Introduction Haemodialysis is one of the widely used methods in end stage renal disease. However it has a negative impact on the quality of life of the renal patients. Hypoalbuminaemia occur in haemodialysis patients and it correlates strongly with mortality and morbidity. We sought out to determine the prevalence of hypoalbuminaemia among haemodialysis patients at Parirenyatwa group of hospitals and Chitungwiza central hospital. Methods A questionnaire was administered on haemodialysis patients at Parirenyatwa Group of Hospitals and Chitungwiza Central Hospital who consented to participate in the study. Pre dialysis serum samples collected from the patients were used for albumin analysis. The serum from the patients was analysed for serum albumin levels using the Mindray BS120 chemistry analyser using the bromocresol green method. Results A total of 60 patients were recruited from the two hospitals. The Mean albumin concentration for the entire group was 33.6g/L SD (6.1 g/L). The mean albumin in males was 33.6 g/L, SD (5.9) and in female 33.6, SD (6.6 g/L) and this was not statistically significantly different (p = 0.988). The prevalence of hypoalbuminaemia was 76.7%. Conclusion Hypoalbuminaemia in 76.7% of haemodialysis patients studied is a cause of concern thus monitoring of haemodialysis patients albumin is necessary since its decreased levels has been associated with increased morbidity and mortality. PMID:26491522

Zimbabwe is a land-locked plateau country of 151,000 square miles, divided into 8 provinces, in Southeastern Africa, bordered by South Africa, Botswana, Zambia and Mozambique. Its population consists of 8.8 million blacks, divided between the Shona-speaking Mashona (80%) and the Sindebele-speaking Matabele (19%), 100,000 whites, 20,000 coloreds, and 10,000 Asians. Many of the blacks are Christians. More than 1/2 the whites migrated to Zimbabwe after the Second World War at a rate of about 1000 a year until the mid-1970s; since then 12,000 whites have left the country. The official language is English, and education is free. Most African children 5-19 years old attend school, and literacy is between 40% and 50%. The University of Zimbabwe is located in Harare, the capital, and there are several technical institutes and teacher-training colleges. Zimbabwe has been inhabited since the stone age, and evidence of a high indigenous civilization remains in the "Great Zimbabwe Ruins" near Masvingo. The present black population is descended from later migrations of Bantu people from central Africa. Cecil Rhodes was granted concessions for mineral rights in the area in 1888, and the territory, which administered by the British South Africa Company, was called Rhodesia. Southern Rhodesia became a self-governing entity within the British Empire in 1913. In 1953 Southern Rhodesia was joined with the British protectorates of Northern Rhodesia and Nyasaland in the Central African Federation, but this dissolved in 1963, and Northern Rhodesia and Nyasaland became independent as Zambia and Malawi in 1964. Independence was withheld from Rhodesia because Prime Minister Ian Smith refused to give Britain assurances that the country would move toward majority rule. In 1965 Smith issued a Unilateral Declaration of Independence (UDI) from the UK. In 1966 the UN Security Council imposed mandatory economic sanctions on Rhodesia. Within Rhodesia the major African nationalist groups -- the

Objective. Treating complications associated with diabetes and hypertension imposes significant costs on health care systems. This study estimated the hospitalization costs for inpatients in a public hospital in Zimbabwe. Methods. The study was retrospective and utilized secondary data from medical records. Total hospitalization costs were estimated using generalized linear models. Results. The median cost and interquartile range (IQR) for patients with diabetes, $994 (385-1553) mean $1319 (95% CI: 981-1657), was higher than patients with hypertension, $759 (494-1147) mean $914 (95% CI: 825-1003). Female patients aged below 65 years with diabetes had the highest estimated mean costs ($1467 (95% CI: 1177-1828)). Wound care had the highest estimated mean cost of all procedures, $2884 (95% CI: 2004-4149) for patients with diabetes and $2239 (95% CI: 1589-3156) for patients with hypertension. Age below 65 years, medical procedures (amputation, wound care, dialysis, and physiotherapy), the presence of two or more comorbidities, and being prescribed two or more drugs were associated with significantly higher hospitalization costs. Conclusion. Our estimated costs could be used to evaluate and improve current inpatient treatment and management of patients with diabetes and hypertension and determine the most cost-effective interventions to prevent complications and comorbidities. PMID:27403444

Objective. Treating complications associated with diabetes and hypertension imposes significant costs on health care systems. This study estimated the hospitalization costs for inpatients in a public hospital in Zimbabwe. Methods. The study was retrospective and utilized secondary data from medical records. Total hospitalization costs were estimated using generalized linear models. Results. The median cost and interquartile range (IQR) for patients with diabetes, $994 (385–1553) mean $1319 (95% CI: 981–1657), was higher than patients with hypertension, $759 (494–1147) mean $914 (95% CI: 825–1003). Female patients aged below 65 years with diabetes had the highest estimated mean costs ($1467 (95% CI: 1177–1828)). Wound care had the highest estimated mean cost of all procedures, $2884 (95% CI: 2004–4149) for patients with diabetes and $2239 (95% CI: 1589–3156) for patients with hypertension. Age below 65 years, medical procedures (amputation, wound care, dialysis, and physiotherapy), the presence of two or more comorbidities, and being prescribed two or more drugs were associated with significantly higher hospitalization costs. Conclusion. Our estimated costs could be used to evaluate and improve current inpatient treatment and management of patients with diabetes and hypertension and determine the most cost-effective interventions to prevent complications and comorbidities. PMID:27403444

In Zimbabwe, a reproductive health survey conducted in 1984 revealed the highest rate of contraceptive use in sub-Saharan Africa -- 38% of currently married women were using some form of family planning and 27% a modern contraceptive method. The majority of Zimbabwe's population, a country formerly known a Rhodesia, is African, but there also are about 100,000 whites, 20,000 persons of mixed race, and 10,000 Asians. Robert Mugabe formed the 1st government of Zimbabwe as a result of elections held in February 1980. Since independence, rifts have developed between the black nationalist leaders -- Robert Mugabe and Joshua Nkomo -- and continues. Some guerrilla activity has occurred in rural areas and antigovernment dissidence creating security and economic problems. Zimbabwe has a broad range of natural resources -- large mineral deposits including coal, asbestos, copper, nickel, gold, and iron ore. In addition to a well-developed electrical power network, there is a good infrastructure of paved roads and a vital railroad link with neighboring South Africa. Due to the trade sanctions imposed between 1965 and independence, the country has had to look inward for production. The manufacturing sector is well developed as is agriculture. The government identifies the country's most urgent problems as the resettlement of displaced persons and reconstruction of roads, health establishments, and schools destroyed during guerrilla activity. PMID:12315399

The model of care of people living with HIV/AIDS (PLWHA) has shifted from hospital care to community home-based care (CHBC) because of shortage of space in hospitals and lack of resources. We evaluate the costs and benefits of home-based care and other HIV/AIDS intervention strategies in Zimbabwe, using an interdisciplinary approach which weaves together the techniques of an epidemic transmission model and economic evaluation concepts. The intervention strategies considered are voluntary counselling and testing (VCT), VCT combined with hospitalization (H), VCT combined with CHBC, and all the interventions implemented concurrently. The results of the study indicate that implementing all the strategies concurrently is the most cost-effective, a result which also agrees with the epidemiological model. Our results also show that the effectiveness of a strategy in the epidemiological model does not necessarily imply cost-effectiveness of the strategy and behaviour change, modelled by the parameters p and m, that accompanied the strategies, influencing both the cost-effectiveness of an intervention strategy and dynamics of the epidemic. This study shows that interdisciplinary collaborations can help in improving the accuracy of predictions of the course and cost of the epidemic and help policy makers in implementing the correct strategies.

The model of care of people living with HIV/AIDS (PLWHA) has shifted from hospital care to community home-based care (CHBC) because of shortage of space in hospitals and lack of resources. We evaluate the costs and benefits of home-based care and other HIV/AIDS intervention strategies in Zimbabwe, using an interdisciplinary approach which weaves together the techniques of an epidemic transmission model and economic evaluation concepts. The intervention strategies considered are voluntary counselling and testing (VCT), VCT combined with hospitalization (H), VCT combined with CHBC, and all the interventions implemented concurrently. The results of the study indicate that implementing all the strategies concurrently is the most cost-effective, a result which also agrees with the epidemiological model. Our results also show that the effectiveness of a strategy in the epidemiological model does not necessarily imply cost-effectiveness of the strategy and behaviour change, modelled by the parameters p and m, that accompanied the strategies, influencing both the cost-effectiveness of an intervention strategy and dynamics of the epidemic. This study shows that interdisciplinary collaborations can help in improving the accuracy of predictions of the course and cost of the epidemic and help policy makers in implementing the correct strategies. PMID:27437475

Indigenous natural drugs are in common use in Zimbabwe because modern life-saving drugs are beyond the reach of nearly 85% of the population. These natural drugs have caused a number of poisoning cases. In a study of the records of four hospitals from 1971 to 1982, carried out to see how many people had been poisoned with herbal remedies, it was found that the number had increased since 1971. 50 traditional healers were questioned about record-keeping and knowledge of toxicity and Health Assistants were also interviewed. PMID:3798540

The teenage suicide rate in Zimbabwe did not change much during the 1970s, though the rate rose for female teenagers. Female teenagers used poison as a method of suicide more often than did adults, and self-immolation had increased in frequency among young women by the mid-1980s. (Author)

The coal potential of Zimbabwe is not widely known, but the country has proved and inferred reserves of around 30,000,000,000 metric tons and intends to become an exporter by 1985. At present there is only one operating coal company in Zimbabwe, the Wankie Colliery Company Limited, but the interest in other coalfields is intensifying. Coal is seen as one of the country's resources with the greatest potential for production increases. The plan is to export 5,000,000 tons per year by 1985, increasing to 10,000,000 tons by 1990. Current exports are insignificant. Current production, from Wankie, is around 3,000,000 tons per year but, with the construction of a new power station, this is to be increased to 7,000,000 tons. Wankie currently operates two underground and three open pit mines.

Following a massive educational expansion initiative by the government of Zimbabwe since 1980, the country has achieved one of the highest literacy rates in Africa. There is legislation in Zimbabwe which makes education a right for every child. In spite of this legislation, special education in Zimbabwe still lags behind the entire educational…

The Bulawayo City Council Health Services Department launched a peer education program for sex workers in 1990. It consisted of formal meetings, informal outreach, condom distribution, and strengthening of sexually transmitted diseases services. Assessment was built in from the start in the form of monitoring, process ethnography, and outcome evaluation. 153 female prostitutes and 74 male sex clients were interviewed at baseline; follow-up interviews were held 1 year later with 48 prostitutes and 58 clients. These interviews revealed that 90% of women and 50% of men had attended program health education meetings; 96% of women and 69% of men had received condoms from the program; and condom use increased significantly among both men and women, although potential errors in the outcome data and their interpretation are acknowledged. The younger, better-educated women fluent in English initially recruited as peer educators were resented by older, less-educated women from rural areas. Attrition was also problematic among younger women as they left the business to enter other forms of employment and marriage. The most effective training proved to be practical, field-oriented, job-related, and frequently repeated and reinforced; regular field supervision was important. Further, the program found that interventions must discourage dependency among participants and instead promote cohesive, self-reliant groups. All people who are even remotely involved in such programs must be sensitized. This program is being replicated in other areas of Zimbabwe as well as in Siavonga, Zambia. PMID:12287482

Religion affects people's daily lives by solving social problems, although it creates others. Female sexual and reproductive health are among the issues most affected by religion. Apostolic sect members in Zimbabwe have been associated with higher maternal mortality. We explored apostolic beliefs and practices on maternal health using 15 key informant interviews in 5 purposively selected districts of Zimbabwe. Results show that apostolicism promotes high fertility, early marriage, non-use of contraceptives and low or non-use of hospital care. It causes delays in recognizing danger signs, deciding to seek care, reaching and receiving appropriate health care. The existence of a customized spiritual maternal health system demonstrates a huge desire for positive maternal health outcomes among apostolics. We conclude that apostolic beliefs and practices exacerbate delays between onset of maternal complications and receiving help, thus increasing maternal risk. We recommend complementary and adaptive approaches that address the maternal health needs of apostolics in a religiously sensitive manner. PMID:27509018

Religion affects people’s daily lives by solving social problems, although it creates others. Female sexual and reproductive health are among the issues most affected by religion. Apostolic sect members in Zimbabwe have been associated with higher maternal mortality. We explored apostolic beliefs and practices on maternal health using 15 key informant interviews in 5 purposively selected districts of Zimbabwe. Results show that apostolicism promotes high fertility, early marriage, non-use of contraceptives and low or non-use of hospital care. It causes delays in recognizing danger signs, deciding to seek care, reaching and receiving appropriate health care. The existence of a customized spiritual maternal health system demonstrates a huge desire for positive maternal health outcomes among apostolics. We conclude that apostolic beliefs and practices exacerbate delays between onset of maternal complications and receiving help, thus increasing maternal risk. We recommend complementary and adaptive approaches that address the maternal health needs of apostolics in a religiously sensitive manner. PMID:27509018

Contracting is increasingly recommended to developing countries as a way of improving the efficiency of the health sector. However, empirical evidence regarding its effectiveness in this respect is almost completely absent. In Zimbabwe, a long standing contract exists between the Ministry of Health and Wankie Colliery to provide clinical services in the Colliery's 400 bed hospital. This paper details a study of the Zimbabweans' experience with the contract. Its success is assessed using comparisons with a neighbouring government hospital of the price of services (vs the cost in the government hospital); the situation of hospital workers; and the quality of services delivered. The Colliery has established a monopoly position for hospital services in the district. However, it appears to offer services of at least as good quality at prices which are lower than the unit costs of the government hospital when capital costs are included. Nevertheless, the contract cannot be considered a success due to the failure to contain its total cost. Approximately 70% of provincial non-salary recurrent expenditure is consumed by the contract while only a minority of the province's population have access to the Colliery hospital. Screening patients, both with respect to their ability to pay and to their need for secondary level services does not take place with the result that utilization levels are not controlled. The study highlights a number of important issues affecting contracting in developing country setting: First, contracted institutions attain powerful bargaining positions if there are no viable competitors and the government does not itself retain capacity to offer an alternative service. Second, specific skills are needed for the management of contracts at all levels. If the process of contract development responds to a crisis driven agenda resulting from civil service retrenchment and public expenditure cuts, it is unlikely that adequate consideration will be given to

The need to address contextual variables, such as cultural bias and cultural norms, is a common challenge for researchers in international education. This article highlights societal conditions and cultural issues that could have impacted teacher efficacy data in Zimbabwe, a country known for its ongoing economic crisis, political repression, and…

The purpose of this article is to discuss Zimbabwe's public education system. First, the article provides a brief look at pre-independence education in Zimbabwe. Second, it discusses some of the reforms that took place in the Zimbabwe education system following independence. Third, it looks at the current structure of Zimbabwe's education system…

Control of the sexually transmitted diseases (STDs) is one of the immense medical problems facing Zimbabwe. The recent war has seriously disrupted the medical services, which used to be one of the best in Africa. Health care facilities for the STDs are limited, but the enthusiasm and determination of the medical and allied professions--together with the potential wealth of the country--should lead to a steady improvement. PMID:6894562

Predictors of Zimbabwe summer rainfall are investigated with a view to improved long-range forecasts. Teleconnectivity is assessed in respect of sea-surface temperatures, the Southern Oscillation index, the Quasi-biennial Oscillation (QBO), outgoing longwave radiation (OLR) and wind. Spectral analyses of historical rainfall gives an indication of cycles in the range 2.3, 18 and 3.8 years, possibly associated with the QBO, the luni-solar tide and the El No-Southern Oscillation (ENSO), respectively. Pair-wise correlations are found between Zimbabwe summer rainfall and SST in the central Indian Ocean (rZimbabwe. The models use three to five predictors, are trained over a 22-year period and perform well in jack-knife skill tests. Summer rainfall forecasts with one season lead times are viable and could ameliorate hardship caused by drought.

Zimbabwe's agricultural biotechnology research capacity is located at universities, government research institutions and parastatal (state funded) organizations. Projects range from those using traditional biotechnology to a few that are experimenting with genetically modified organisms (GMOs). PMID:11590069

Since the International Monetary Fund/World Bank Economic Structural Adjustment Program (ESAP) in Zimbabwe was adopted in 1990, health care and education costs have escalated, and many people fail to get these services owing to poverty. The post-independence era in Zimbabwe witnessed a tremendous growth in education and health with many schools, colleges, hospitals and clinics built, professional staff employed, and a general expansion in demand. Nevertheless, the question of drug shortages and ever-increasing health care costs were not addressed. A deficient transport network, the increases in drug prices, the exodus of professional staff, the devaluation of the Zimbabwe dollar, and the cost recovery measures endangered the right to acceptable health care. The social service cutbacks adopted by the government in education will deepen poverty. After independence, the Zimbabwean education system had a free tuition policy at primary school levels. Now that the government reintroduced school fees, a generation of illiterate and semi-illiterate school dropouts will grow up. The social implications of this include increases in crime, prostitution, the number of street kids, the spread of diseases, and social discontent, which are the symptoms of a shrinking economy. As a result of the cost recovery measures, school enrollment in rural areas has gone up. Some urban parents have been forced to transfer their children to rural schools. Higher education also suffers, as government subsidies to colleges and universities have been drastically curtailed. The budgetary cuts have grave repercussions for teaching and research, as poor working conditions and low morals of lecturers and students become prevalent. Most wage-earning Zimbabweans' living standards have deteriorated as the cost of living continues to escalate, coupled with the cost recovery measures in the name of ESAP. PMID:12287629

Temperament styles of 600 Zimbabwe children are described and compared to those of 3,200 U.S. children. Gender and age differences are described for children in Zimbabwe and compared to U.S. children. Results indicate that Zimbabwe children generally prefer extroverted to introverted styles, practical to imaginative styles, feeling to thinking…

The great hope and promise of post-independence efforts to promote equitable health care in Zimbabwe started with three years of dramatic improvement. Commitment to correcting inequities which were as discriminatory as any country in the world produced rapid extension of health centre infrastructure and the improvement of district hospitals. The major constraint was the entrenched pattern of sophisticated, high-technology health care left by colonial administrators which continued to monopolize resources. In spite of the excellent beginning, development of services for the poor was thwarted by recession, prolonged drought and external military destabilization. The cutbacks in funding for health care have been particularly severe as a result of economic adjustment policies imposed by IMF. Political pressure moved the health system toward private entrepreneurship returning to earlier patterns of discrimination in favour of whites and urban residents. Efforts to promote high-risk monitoring have had little impact among the poor and those living in remote areas. Equity has become symbolic rather than real. The government of Zimbabwe maintains a continuing commitment to the original goals of equity through primary health care. International agencies also would like to find a way to help reallocate services. There seems to be recognition that little will be accomplished in improving health conditions unless services are provided to those in greatest need. Disparities in maternal care are especially severe and can be improved only by building infrastructure to provide antenatal and perinatal services.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8017085

Background Zimbabwe underwent a socioeconomic crisis and resultant increase in food insecurity in 2008–9. The impact of the crisis on Tuberculosis (TB) incidence is unknown. Methods Prospective databases from two mission hospitals, which were geographically widely separated, and remained open during the crisis, were reviewed. Results At the Howard Hospital (HH) in northern Zimbabwe, TB incidence increased 35% in 2008 from baseline rates in 2003–2007 (p<0.01) and remained at that level in 2009. Murambinda Hospital (MH) in Eastern Zimbabwe also demonstrated a 29% rise in TB incidence from 2007 to 2008 (p<0.01) and remained at that level in 2009. Data collected post-crisis at HH showed a decrease of 33% in TB incidence between 2009 to 2010 (p<0.001) and 2010/2011 TB incidence remained below that of the crisis years of 2008/2009 (p<0.01). Antenatal clinic HIV seroprevalence at HH decreased between 2001(23%) to 2011(11%) (p<0.001). Seasonality of TB incidence was analyzed at both MH and HH. There was a higher TB incidence in the dry season when food is least available (September-November) compared to post harvest (April-June) (p<0.001). Conclusion This study suggests that an epidemic of TB mirrored socioeconomic collapse and recovery in Zimbabwe. The seasonal data suggests that food security may have been associated with TB incidence both annually and during the crisis in this high HIV prevalence country. PMID:24505245

The present study examines intimate partner violence (IPV) reported by a sample of women in Zimbabwe to explore factors associated with the problem. Findings from the study indicate an important role of gender relationships in violence against women. The effects of gender inequalities on the likelihood of IPV vary with types of violence, but husband's patriarchal behaviors increase the likelihood of all forms of violence. The study suggests the importance of improving gender equality through public education on gender relationships, increasing women's education and economic opportunities, and eliminating customary laws that sustain gender inequality as necessary steps to combat IPV against women in Zimbabwe. PMID:26644331

Zimbabwe is a mineral-rich country with a long history of Earth Science Education. The establishment of a University Geology Department in 1960 allowed the country to produce its own earth science graduates. These graduates are readily absorbed by the mining industry and few are without work. Demand for places at the University is high and entry standards reflect this. Students enter the University after GCE A levels in three science subjects and most go on to graduate. Degree programmes include B.Sc. General in Geology (plus another science), B.Sc. Honours in Geology and M.Sc. in Exploration Geology and in Geophysics. The undergraduate curriculum is broad-based and increasingly vocationally orientated. A well-equipped building caters for relatively large student numbers and also houses analytical facilities used for research and teaching. Computers are used in teaching from the first year onwards. Staff are on average poorly qualified compared to other universities, but there is an impressive research element. The Department has good links with many overseas universities and external funding agencies play a strong supporting role. That said, financial constraints remain the greatest barrier to future development, although increasing links with the mining industry may cushion this.

A program started during a drought in Zimbabwe involved the cultivation of drought-resistant crops. The program made the women less dependent on their often-absent husbands and changed the relationship between men and women in the village. (JOW)

This study explored Ndebele culture of Zimbabwe's views of giftedness. Using questionnaire narratives, data were collected from thirty Zimbabwean teachers and lecturers of Ndebele cultural background. The study established that Ndebele culture views giftedness as an unusually outstanding ability blessed in an individual from birth, which manifests…

The purpose of this study was to investigate the pathways of entrepreneurial career development and the processes involved for women to become entrepreneurs in Zimbabwe. Women entrepreneurs were studied to gain an understanding of why women chose self-employment and how local enterprise programs should be designed to benefit them. The study…

... Office of Foreign Assets Control Publication of General License Related to the Zimbabwe Sanctions Program... General License No. 1 issued under the Zimbabwe sanctions program on April 24, 2013. Zimbabwe General License No. 1 authorizes all transactions involving Agricultural Development Bank of Zimbabwe...

Across the globe, the emergence of complex societies excites intense academic debate in archaeology and allied disciplines. Not surprisingly, in southern Africa the traditional assumption that the evolution of socio-political complexity began with ideological transformations from K2 to Mapungubwe between CE1200 and 1220 is clouded in controversy. It is believed that the K2-Mapungubwe transitions crystallised class distinction and sacred leadership, thought to be the key elements of the Zimbabwe culture on Mapungubwe Hill long before they emerged anywhere else. From Mapungubwe (CE1220-1290), the Zimbabwe culture was expressed at Great Zimbabwe (CE1300-1450) and eventually Khami (CE1450-1820). However, new fieldwork at Mapela Hill, when coupled with a Bayesian chronology, offers tremendous fresh insights which refute this orthodoxy. Firstly, Mapela possesses enormous prestige stone-walled terraces whose initial construction date from the 11th century CE, almost two hundred years earlier than Mapungubwe. Secondly, the basal levels of the Mapela terraces and hilltop contain élite solid dhaka (adobe) floors associated with K2 pottery and glass beads. Thirdly, with a hilltop and flat area occupation since the 11th century CE, Mapela exhibits evidence of class distinction and sacred leadership earlier than K2 and Mapungubwe, the supposed propagators of the Zimbabwe culture. Fourthly, Mapungubwe material culture only appeared later in the Mapela sequence and therefore post-dates the earliest appearance of stone walling and dhaka floors at the site. Since stone walls, dhaka floors and class distinction are the essence of the Zimbabwe culture, their earlier appearance at Mapela suggests that Mapungubwe can no longer be regarded as the sole cradle of the Zimbabwe culture. This demands not just fresh ways of accounting for the rise of socio-political complexity in southern Africa, but also significant adjustments to existing models. PMID:25360782

Across the globe, the emergence of complex societies excites intense academic debate in archaeology and allied disciplines. Not surprisingly, in southern Africa the traditional assumption that the evolution of socio-political complexity began with ideological transformations from K2 to Mapungubwe between CE1200 and 1220 is clouded in controversy. It is believed that the K2−Mapungubwe transitions crystallised class distinction and sacred leadership, thought to be the key elements of the Zimbabwe culture on Mapungubwe Hill long before they emerged anywhere else. From Mapungubwe (CE1220–1290), the Zimbabwe culture was expressed at Great Zimbabwe (CE1300–1450) and eventually Khami (CE1450–1820). However, new fieldwork at Mapela Hill, when coupled with a Bayesian chronology, offers tremendous fresh insights which refute this orthodoxy. Firstly, Mapela possesses enormous prestige stone-walled terraces whose initial construction date from the 11th century CE, almost two hundred years earlier than Mapungubwe. Secondly, the basal levels of the Mapela terraces and hilltop contain élite solid dhaka (adobe) floors associated with K2 pottery and glass beads. Thirdly, with a hilltop and flat area occupation since the 11th century CE, Mapela exhibits evidence of class distinction and sacred leadership earlier than K2 and Mapungubwe, the supposed propagators of the Zimbabwe culture. Fourthly, Mapungubwe material culture only appeared later in the Mapela sequence and therefore post-dates the earliest appearance of stone walling and dhaka floors at the site. Since stone walls, dhaka floors and class distinction are the essence of the Zimbabwe culture, their earlier appearance at Mapela suggests that Mapungubwe can no longer be regarded as the sole cradle of the Zimbabwe culture. This demands not just fresh ways of accounting for the rise of socio-political complexity in southern Africa, but also significant adjustments to existing models. PMID:25360782

A study was conducted to investigate the future of woodworking in primary schools in Zimbabwe. Although such subjects have generally been organized along the same lines as traditional academic subjects, strategies vary from one country to another and so do the problems. The investigation covered all the primary schools in Zimbabwe teaching…

When Zimbabwe gained independence in 1980, the government started a massive expansion of the education system. Two decades later, the country's literacy rate had risen to one of the highest in sub-Saharan Africa. However, the same cannot be said for special education. This paper examines the development of the education system in Zimbabwe with…

Background There are limited published data on the characteristics of blood transfusion recipients in sub-Saharan Africa. This study describes the demographic characteristics of blood transfusion recipients and patterns of blood and blood component use in Zimbabwe. Materials and methods Data on the characteristics of the blood transfusion recipients (age, sex, blood group), blood components received (type, quantity), discharge diagnoses and outcomes following transfusion (discharge status, duration of stay in hospital), were retrospectively collected from four major hospitals for the period from January 1, 2012 to December 31, 2012. Diagnoses were grouped into broad categories according to the disease headings of the International Classification of Diseases (ICD-10). Surgical procedures were grouped into broad categories according to organ system using ICD-9. Results Most of the 1,793 transfusion recipients studied were female (63.2%) and in the reproductive age group, i.e. 15–49 years (65.3%). The median age of the recipients was 33 years (range, 0–93). The majority of these recipients (n=1,642; 91.6%) received a red blood cell transfusion. The majority of the patients were diagnosed with conditions related to pregnancy and childbirth (22.3%), and diseases of blood and blood-forming organs (17.7%). The median time spent in hospital was 8 days (range, 0–214) and in-hospital mortality was 15.4%. Discussion Our sample of blood transfusion recipients were fairly young and most of them received red blood cell transfusions. The majority of patients in the reproductive age group received blood transfusions for pregnancy and childbirth-related diagnoses. PMID:26192782

This study examines young people's access to reproductive healthcare services via an urban youth advisory centre in Bulawayo, Zimbabwe. The aim is to explain why teenagers do not always use existing health services. Data from exit questionnaires with users and focus groups with non-users are analysed to evaluate service accessibility. Analysis suggests that even where clinics are spatially accessible, barriers to access include temporal factors, lack of factual knowledge and stigmatisation. The paper concludes that spatial accessibility is not the only factor necessary to ensure equal access to health services. Recommendations are made towards tackling young people's unmet needs for reproductive healthcare services. PMID:12399216

To obtain maximum yield of ethanol from sugar and to dispose of the stillage in the most effective economic way possible are the main problems facing Zimbabwe's fuel ethanol industry. In order to monitor the production of ethanol from sugar cane, High Pressure Liquid Chromatography is used as it is a simple method and the results are reproducible, accurate and produced with little delay. In order to dispose of the stillage, it has been used as a fertilizer and as animal feed but incineration and microbiological digestion of the stillage may provide better long-term solutions.

The Great Dike of Zimbabwe (17.5S, 31.5E) bisects the entire length of Zimbabwae in southern Africa and is one of the prominent visual features easily recognized from low orbit. The volcanic rocks which make up the dike are about 1.2 billion years old and are rich in chromite and platinum which are mined from it. The straight line of the dike is offset in places by faults which are often occupied by streams flowing through the fractures.

This technical paper provides a broad analysis of forestry policy in Zimbabwe. Some two dozen contributors look at forestry as a provider of livelihood, homes and workplaces, and industrial commodities. The first section of the paper concentrates on the social and macroeconomic goals of forestry in Zimbabwe and on its place in rural agriculture. Contributors examine the issues of land tenure and the culture of common property, the practice of woodland management, and control of and participation in management and policy development. The second section focuses on the status of the forest industry in Zimbabwe and on its capacity to manage and expand existing commercial plantations. The paper explores the main issues the sector faces, including growing concentration of ownership versus the government`s objective of wider participation in the industry. They discuss the effects of trade liberalization on its competitive position, both among other agricultural sectors within Zimbabwe and with competitors outside the country. Included is a color map of Zimbabwe`s woodlands. Many forestry programs worldwide face the issues discussed in this work. It will be of interest to planners, policymakers, teachers, and students of rural development and forestry.

In 1980, Zimbabwe rapidly expanded access to secondary schools, providing a natural experiment to estimate the impact of increased maternal secondary education on child mortality. Exploiting age specific exposure to these reforms, we find that children born to mothers most likely to have benefited from the policies were about 21% less likely to die than children born to slightly older mothers. We also find that increased education leads to delayed age at marriage, sexual debut, and first birth and that increased education leads to better economic opportunities for women. We find little evidence supporting other channels through which increased education might affect child mortality. Expanding access to secondary schools may greatly accelerate declines in child mortality in the developing world today. PMID:26569469

"This paper critically evaluates the causes and consequences of changes in population distribution in Zimbabwe during the colonial period and since independence in 1980. Five main aspects of population geography are examined. Firstly...the history of tenure policies is outlined. Secondly, the distribution of the African population as revealed in the 1982 census is described and major changes between the census years of 1962, 1969, and 1982 are discussed. Thirdly, changing patterns of settlement and land use within the peasant farming areas (Communal Lands) are examined in the context of increasing population pressures. Fourthly, trends in the...urbanisation of the African population are described. Fifthly, post-independence development policies directed at effecting changes in the distribution of population are discussed with particular reference to the land resettlement programme." PMID:12268679

As the first phase of a two-phase prospective cohort study to assess the acceptability of the diaphragm as a potential HIV/STI prevention method, we conducted a 2-month prospective study and examined the effect of a male and female condom intervention on female condom (FC) use among 379 sexually active women in Harare, Zimbabwe. Reported use of FC increased from 1.1% at baseline to 70.6% at 2-month follow-up. Predictors of FC uptake immediately following the intervention included interest in using FC, liking FC better than male condoms, and believing one could use them more consistently than male condoms. Women reported 28.8% of sex acts protected by FC in the 2 weeks prior to last study visit. Though FC may not be the preferred method for the majority of women, with access, proper education, and promotion they may be a valuable option for some Zimbabwean women. PMID:18433318

... to the Situation in Zimbabwe Presidential Documents Other Presidential Documents Notice of March 1, 2013 Continuation of the National Emergency With Respect to the Situation in Zimbabwe On March 6, 2003... persons undermining democratic processes or institutions in Zimbabwe, pursuant to the...

... to the Situation in Zimbabwe Presidential Documents Other Presidential Documents Notice of March 2, 2012 Continuation of the National Emergency With Respect to the Situation in Zimbabwe On March 6, 2003... persons undermining democratic processes or institutions in Zimbabwe, pursuant to the...

... to Zimbabwe Presidential Documents Other Presidential Documents Notice of March 3, 2009 Continuation of the National Emergency With Respect to Zimbabwe On March 6, 2003, by Executive Order 13288, the... or institutions in Zimbabwe, pursuant to the International Emergency Economic Powers Act (50...

This monograph focuses on the development of colonial and post-colonial language policies and practices in Zimbabwe, attributing changes to evolving philosophies and politics in colonial and post-colonial Zimbabwe. In colonial Zimbabwe, we argue that the language policies had as one of their key objectives the development of a bilingual white…

... to Zimbabwe Presidential Documents Other Presidential Documents Notice of March 2, 2011 Continuation of the National Emergency With Respect to Zimbabwe On March 6, 2003, by Executive Order 13288, the... or institutions in Zimbabwe, pursuant to the International Emergency Economic Powers Act (50...

Little research has been conducted on how pre-existing indigenous community resources, especially social networks, affect the success of externally imposed HIV interventions. Antiretroviral treatment (ART), an externally initiated biomedical intervention, is being rolled out across sub-Saharan Africa. Understanding the ways in which community networks are working to facilitate optimal ART access and adherence will enable policymakers to better engage with and bolster these pre-existing resources. We conducted 67 interviews and eight focus group discussions with 127 people from three key population groups in Manicaland, eastern Zimbabwe: healthcare workers, adults on ART and carers of children on ART. We also observed over 100 h of HIV treatment sites at local clinics and hospitals. Our research sought to determine how indigenous resources were enabling people to achieve optimal ART access and adherence. We analysed data transcripts using thematic network technique, coding references to supportive community networks that enable local people to achieve ART access and adherence. People on ART or carers of children on ART in Zimbabwe report drawing support from a variety of social networks that enable them to overcome many obstacles to adherence. Key support networks include: HIV groups; food and income support networks; home-based care, church and women's groups; family networks; and relationships with healthcare providers. More attention to the community context in which HIV initiatives occur will help ensure that interventions work with and benefit from pre-existing social capital. PMID:23503291

Little research has been conducted on how pre-existing indigenous community resources, especially social networks, affect the success of externally imposed HIV interventions. Antiretroviral treatment (ART), an externally initiated biomedical intervention, is being rolled out across sub-Saharan Africa. Understanding the ways in which community networks are working to facilitate optimal ART access and adherence will enable policymakers to better engage with and bolster these pre-existing resources. We conducted 67 interviews and eight focus group discussions with 127 people from three key population groups in Manicaland, eastern Zimbabwe: healthcare workers, adults on ART and carers of children on ART. We also observed over 100 h of HIV treatment sites at local clinics and hospitals. Our research sought to determine how indigenous resources were enabling people to achieve optimal ART access and adherence. We analysed data transcripts using thematic network technique, coding references to supportive community networks that enable local people to achieve ART access and adherence. People on ART or carers of children on ART in Zimbabwe report drawing support from a variety of social networks that enable them to overcome many obstacles to adherence. Key support networks include: HIV groups; food and income support networks; home-based care, church and women's groups; family networks; and relationships with healthcare providers. More attention to the community context in which HIV initiatives occur will help ensure that interventions work with and benefit from pre-existing social capital. PMID:23503291

Traditional medicine is the source of primary care for most Zimbabweans. N'angas (traditional healers) are consulted for their political and religious powers along with their healing powers. The Zimbabwe National Traditional Healers Association was formed and is officially recognized by the government and has a constitution along with departments of education and research. Each member pays annual dues. Herbal remedies are used. Most n'angas say they are possessed by a healing spirit which they invoke while treating the patient. These n'angas practice specialization--the extent to which the n'angas claim expertise, outside of which they will refer a patient to others. The referral and specialization practices of a select group of n'angas in and around the capital, Harare are studied. 30 n'angas from 7 suburbs of harare were interviewed personally at their place of practice in 1987. All 30 claimed to specialize in the treatment of certain illnesses. They specialized in spiritual, not just medical, problems. The n'angus referred to other n'angas for either or both of 2 reasons: 1) most referred patients for whom their treatment had failed; and 2) patients were referred for suffering an illness which that certain n'anga could not cure, usually because their healing spirit did not give them the cure. There were some things that the n'angas would only send to western medical practitioners and hospitals. These were mostly accidents or emergencies. "Abnormal illnesses" were never referred to Western practitioners and hospitals. "Abnormal illnesses" were caused by evil spirits such as "ngozi." The n'angas were divided over what to do about the acquired immunodeficiency syndrome (AIDS). 1 n'anga sand that he was so good at curing AIDS that he was flown to America to treat a patient. Others would send AIDS patients to hospitals. Most all Zimbabwe natives are descended from Shona and Ndebele cultures. PMID:2219419

OBJECTIVE: To investigate the factors associated with attitudes towards wife beating among women in partnerships in Zimbabwe in order to assist public health practitioners in preventing intimate partner violence (IPV). METHODS: A nationally representative survey of 5907 women of reproductive age (15-49 years) was conducted in Zimbabwe. Women were asked about their attitudes towards wife beating in five situations. The survey included sociodemographic characteristics, partnership characteristics, and household decision-making. FINDINGS: Over half of all women in Zimbabwe (53%) believed that wife beating was justified in at least one of the five situations. Respondents were most likely to find wife beating justified if a wife argued with her spouse (36%), neglected her children (33%), or went out without telling her spouse (30%). Among women in partnerships (n=3077), younger age, living in rural areas, lower household wealth, schooling at a lower level than secondary, and lower occupational status were associated with women reporting that wife beating is justified. Women who reported that they make household decisions jointly with their partners were less likely to say that wife beating is justified. CONCLUSIONS: Zimbabwe has a long way to go in preventing IPV, particularly because the younger generation of women is significantly more likely to believe that wife beating is justified compared with older women. Given the current social and political climate in Zimbabwe, finding means to negotiate rather than settle conflict through violence is essential from the household level to the national level. PMID:12973642

The training of traditional birth attendants (TBAs) as a national public health strategy was implemented in the late 1970's in Zimbabwe. Since 1982, the Manicaland rural health programs have trained 6000 women in 12-week courses to change their practices of using unsterilized razor blades, shards of glass, or knives to sever the umbilical cord. These practices and others had led to high rates of neonatal tetanus mortality and maternal mortality. TBAs learned from state certified nurses the basics of personal and domestic hygiene, identification of pregnancy and associated risk factors, the importance of good nutrition, rest, and immunization for pregnant women, and safe practices in labor and delivery. Refresher courses and additional training in prenatal care and family planning have been added recently to the program. Completion of the program leads to a public recognition of their graduation in the base village. Maternity care services are provided as back up. This includes village based maternity waiting homes for women in labor, community health workers, and auxiliary midwives with higher level training. A district health center has been set up for more complicated cases. This access to better health care has led to a 50 and 66% reduction in maternal and infant mortality rates, respectively. A 1988 government survey shows increases in the use of contraceptives and the number of women receiving prenatal care. The components of the program which have contributed to program success and provided similarities to other country's TBA programs are as follows: developing a sense of self esteem and pride among TBAs for their work, utilizing creative ways to teach the largely illiterate TBA population through role plays and songs, and providing involvement in the health care system which reaffirms the TBA's importance. In spite of the advancements made however, there are still problems to solve. Unsafe practices are resorted to when TBAs forget their training

This article analyses the factors influencing the attractiveness of the secondary teaching profession in Zimbabwe. The findings are based on data collected from more than 200 non-graduate student teachers by means of a questionnaire, supplemented by documents and interviews. Among the 21 relevant factors listed in the questionnaire, those relating to salary, fringe benefits and working conditions were considered to have the greatest influence. In particular, benefits similar to those of comparable professions in the public and private sectors were identified as crucial. The author broadens the context of his conclusions by comparing the situation in Zimbabwe to that in other developing countries.

This paper discusses the integration of information services in the Parliament of Zimbabwe (PoZ). An organizational chart of the information systems at PoZ in 1999 is provided, and each of the four departments managing information services are described, i.e., the library, the research department, public relations, and information technology. An…

The objective of the study was to document initiatives for enhancing graduate employability and building successful future careers for students. The author used the case of Zimbabwe to explore interventions by higher education institutions, government, industry and commerce as well as professional bodies. The methodology involved a mix of…

Agroforestry has been defined as a sustainable crop management system which combines the production of forest crops with field crops. In June, 1987, an agroforestry workshop took place in Nyanga, Manicaland, Zimbabwe. This document was prepared to share the information presented at this workshop with other non-government organizations around the…

Citizenship education in Zimbabwe is based on the claim that young people lack citizenship virtues. This study set out to investigate these assumptions by assessing high school students' knowledge of, attitudes towards and participation levels in citizenship issues. Findings show that while students are knowledgeable about citizenship issues they…

Counseling in Zimbabwe has a long tradition, dating back to pre-Colonial times. In the modern context, counseling has evolved through the educational and health care sectors. Since the 1990s, Zimbabwean counselors have advocated for professional recognition, a struggle similar to that of counselors in the United States. In this article, the…

Strategies for Hope is a series of booklets and videos about innovative and practical approaches to AIDS management and prevention in developing countries. It is published by the UK development agency ACTIONAID and the African Medical and Research Foundation with technical and financial support from the World Health Organization Global Program on AIDS. More than 500,000 booklets and 5000 videos have been distributed worldwide. The authors describe what they learned while researching the eighth booklet in the series, Work Against AIDS, analyzing seven workplace-based AIDS programs in Zimbabwe. They argue that the workplace can play a far greater role in AIDS awareness and prevention than is generally realized. AIDS is already affecting the health and productivity of the workforce in Zimbabwe, where in some areas more than 15% of adults are estimated to be HIV-positive. Morbidity and mortality are rising with concomitant worker absenteeism, yet most workplaces in Zimbabwe do not have even a poster about AIDS on display. There are, however, some impressive education programs under way. These programs, run by a significant number of volunteer peer educators, are working to reduce the stigma attached with sexually transmitted diseases and promote low-cost or free treatment. The authors also note as most promising the program of the Zimbabwe Congress of Trade Unions training 700 Health and Safety representatives at shop-floor and branch levels in AIDS-related human rights issues at the workplace as well as AIDS awareness and prevention. PMID:12318814

Background Zimbabwe suffers from one of the greatest burdens of HIV/AIDS in the world that has been compounded by social and economic instability in the past decade. However, from 2001 to 2009 HIV prevalence among 15-49 year olds declined from 26% to approximately 14%. Behavior change and condom use may in part explain this decline. PSI-Zimbabwe socially markets the Protector Plus (P+) branded line of condoms. When Zimbabwe converted to a dollar-based economy in 2009, the price of condoms was greatly increased and new marketing efforts were undertaken. This paper evaluates the role of condom marketing, a multi-dimensional scale of brand peceptions (brand equity), and price in condom use behavior. Methods We randomly sampled sexually active men age 15-49 from 3 groups - current P+ users, former users, and free condom users. We compared their brand equity and willingness to pay based on survey results. We estimated multivariable logistic regression models to compare the 3 groups. Results We found that the brand equity scale was positive correlated with willingness to pay and with condom use. Former users also indicated a high willingness to pay for condoms. We found differences in brand equity between the 3 groups, with current P+ users having the highest P+ brand equity. As observed in previous studies, higher brand equity was associated with more of the targeted health behavior, in this case and more consistent condom use. Conclusions Zimbabwe men have highly positive brand perceptions of P+. There is an opportunity to grow the total condom market in Zimbabwe by increasing brand equity across user groups. Some former users may resume using condoms through more effective marketing. Some free users may be willing to pay for condoms. Achieving these objectives will expand the total condom market and reduce HIV risk behaviors. PMID:22029874

An atlas of Zimbabwe and the Southern African Development Community was designed and produced for use by American diplomats in Zimbabwe. Two copies of the bound atlas are used by the Embassy of the United States of America (U.S. Embassy) and the Mission of the U.S. Agency for International Development (USAID) in Harare, Zimbabwe, to orient visitors and discuss matters of diplomacy and development in Zimbabwe and the Southern African Development Community. The atlas contains maps derived from satellite images showing features of the physical geography of Southern Africa and Zimbabwe and plastic overlays showing rivers and lakes and manmade features, such as major roads, railroads, and cities. The atlas is an important tool that American diplomats can use to orient participants in discussions of the environment and to develop agreements for management of the environment in Zimbabwe and Southern Africa.

Background A growing number of studies highlight men's disinclination to make use of HIV services. This suggests there are factors that prevent men from engaging with health services and an urgent need to unpack the forms of sociality that determine men's acceptance or rejection of HIV services. Methods Drawing on the perspectives of 53 antiretroviral drug users and 25 healthcare providers, we examine qualitatively how local constructions of masculinity in rural Zimbabwe impact on men's use of HIV services. Results Informants reported a clear and hegemonic notion of masculinity that required men to be and act in control, to have know-how, be strong, resilient, disease free, highly sexual and economically productive. However, such traits were in direct conflict with the 'good patient' persona who is expected to accept being HIV positive, take instructions from nurses and engage in health-enabling behaviours such as attending regular hospital visits and refraining from alcohol and unprotected extra-marital sex. This conflict between local understandings of manhood and biopolitical representations of 'a good patient' can provide a possible explanation to why so many men do not make use of HIV services in Zimbabwe. However, once men had been counselled and had the opportunity to reflect upon the impact of ART on their productivity and social value, it was possible for some to construct new and more ART-friendly versions of masculinity. Conclusion We urge HIV service providers to consider the obstacles that prevent many men from accessing their services and argue for community-based and driven initiatives that facilitate safe and supportive social spaces for men to openly discuss social constructions of masculinity as well as renegotiate more health-enabling masculinities. PMID:21575149

The trends in drug use, expenditure and disease pattern at the University of Zimbabwe students' health facility over a period of five years (1987-1991), were analysed retrospectively. The study also analysed the use of the essential drugs concept and the drug situation in Zimbabwe. A total of 1,500 cases which were randomly selected were studied. The total student population over this period was 44,030. Data collection sheets where utilised to extract information from patients' cards. Requisition order books and budgets for drugs and medical appliances and student population statistical data were analysed. Males accounted for 75.7 pc of the cases and the average age at the time of the visit was 22.04 years. The percentage of cases involving married students was 2.53 pc of which 94.74 pc were males. The total expenditure of drugs and medical appliances for the study period was $412,413.55 and most of the items were supplied by the Government Medical Stores. The most prevalent disease conditions were respiratory tract infections (35 pc) and urinary tract infections (16.3 pc). The disease pattern differed from that at district, general and provincial hospitals. The total number of drugs dispensed for the 1,500 students was 2,600, giving an average of 1.7 drugs per case. Analgesics were the most widely used drugs (28.5 pc), followed by anti-infectives (28.2 pc). The most popular analgesic used was paracetamol which accounted for 66.6 pc of the analgesics. Antibiotics accounted for 88.1 pc of the anti-infectives and 24.9 pc of the total number of drugs dispensed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8131195

Objectives Despite the advent of antiretroviral therapy (ART), many children, particularly in the rural communities of Zimbabwe, remain vulnerable. The purpose of this study was to determine the factors and challenges facing children on antiretroviral therapy (ART) in Brunapeg area of Mangwe District, Zimbabwe. Methods A mixed-method approach involving interviewer-guided focus group discussions and piloted semi-structured questionnaires was utilized to collect data from different key population groups. The data obtained were analyzed through content coding procedures based on a set of predetermined themes of interest. Results A number of challenges emerged as barriers to the success of antiretroviral therapy for children. Primary care givers were less informed about HIV and AIDS issues for people having direct impact on the success of antiretroviral therapy in children whilst some were found to be taking the antiretroviral drugs meant for the children. It also emerged that some primary care givers were either too young or too old to care for the children while others had failed to disclose to the children why they frequently visited the Opportunistic Infections (OI) clinic. Most primary care givers were not the biological parents of the affected children. Other challenges included inadequate access to health services, inadequate food and nutrition and lack of access to clean water, good hygiene and sanitation. The lack of community support and stigma and discrimination affected their school attendance and hospital visits. All these factors contributed to non-adherence to antiretroviral drugs. Conclusions and Public Health Implications Children on ART in rural communities in Zimbabwe remain severely compromised and have unique problems that need multi-intervention strategies both at policy and programmatic levels. Effective mitigating measures must be fully established and implemented in rural communities of developing countries in the fight for universal

It is concluded that equality for women in education, which was a state aim in 1980, is no longer a state concern in Zimbabwe. It is argued that protection of the patriarchal order has been the operating principle of both colonial and post-colonial periods, and education is used to maintain the gender imbalance. Black women under colonialism were subjected to both sexism and racism. The socioeconomic order was maintained by ensuring that Blacks remained uneducated and unskilled. Colonial policy was race specific. Education was free and compulsory for Whites only. Black parents paid fees for a son's education. Post colonialism and in 1971, only 43.5% of Black children were enrolled in school, of which 3.9% were in secondary school. Only 19 girls with at the highest level in school. School curriculum was gender based, which meant girls were taught cooking and typing. During independence, education policy was instituted, and education was considered as a human right and gender neutral. Tuition fees in primary grades were eliminated, and education was expanded. However, changes after independence did not result in equal advantage for girls. By 1985-91, girls had lower enrollments at all grade levels. The widest gaps in enrollment were at the highest levels. School curriculum changed very little, and girls were directed to the "feminine" courses of study. Girls performed poorly in math and sciences. Girls were underenrolled in technical and vocational institutions. After 1989, structural adjustment programs negatively impacted on women. There was reduced access to employment, limited access to services, and increased demands on women's time in order to compensate for gaps created by cuts in services. New changes in education policy are expected to negatively impact on girl's education. Fees for primary school were reintroduced in urban areas, and secondary school fees were increased. The government dropped the requirement of certification for technical and commercial

In most countries worldwide regulatory bodies set effluent discharge limits into rivers and other natural water bodies. These limits specify the maximum permissible concentration of defined pollutants that may be discharged into the water body. This limit is conceptually based on the self-purification (assimilative) capacity of the receiving water. However, this self-purification constant is itself a function of the water's pollutant loading. Umguza River situated south west of Zimbabwe, is fed by tributaries that drain an urban catchment and as such is prone to pollution due to human activities in the catchment. This study investigated the levels of pollution in Umguza River that would affect its self-purification capacity. This was achieved by characterising the spatial distribution of a selected range of water quality parameters as well as determining the self-purification capacity of a stretch of the river. Critical pollutant concentrations were determined for some of the parameters that showed high values along the stretch. The selected parameters of interest were dissolved oxygen, suspended solids, phosphates, nitrates, COD, turbidity, ammonia, pH, alkalinity and temperature. The study was carried out from January 2014 to April 2014. The self-purification capacity was determined using a formula that compares the mass flux of a pollutant upstream and downstream of the selected stretch of the river. Statistical analysis was used to establish relationships between the pollutants and the self-purification capacity of the river. The study found that the levels of ammonia and phosphates were very high compared to the regulated limits (2 mg/l vs 0.5 mg/l; and 8 mg/l vs 0.5 mg/l respectively). It was also found that the self-purification capacity varied significantly across pollutants. It was therefore concluded that a critical pollutant concentration exists above which the river completely loses its natural ability to assimilate and decrease its pollutant load over

The traditional wastewater management style is now presenting some problems, having evolved from a situation of small communities, little industrial activities, and abundance of freshwater. The style is characterized by high water consumption and large treatment plants that employ sophisticated treatment systems with final effluent discharged to rivers. This paper focuses on analysis and development of an alternative strategy of decentralised wastewater management in Zimbabwe. Serious pollution problems related to inappropriate effluent discharges are prevalent necessitating an efficient and reliable strategy of controlling environmental pollution whilst obtaining optimal benefits from wastewater reuse. A conceptual plan for the decentralised strategy was developed taking into account capital and operational costs, wastewater generation patterns and quality, and urban agriculture. Maize cultivation was used to illustrate the implications of water and nutrient utilisation potential of the strategy. It was concluded that the strategy would suit high and medium density dwellings in Zimbabwe and that greywater separation can be used as part of the strategy.

This paper reports preliminary results from a study of child feeding practices in a rural area of Zimbabwe. Although Zimbabwe has relatively low infant mortality rates, it still has high child malnutrition rates. Several factors, including sex roles and relations between the sexes, access to resources, food costs and availability, time and energy costs of food production and preparation, and illness beliefs and practices, especially those concerning diarrhea and malnutrition, are examined as possible determinants of feeding practices and nutritional and health status. Results are compared to reports made by the World Bank and the Zimbabwe national nutrition survey. Whereas the World Bank report suggests a problem of late introduction of breastmilk supplements or solids, we found the opposite tendency of early introduction (by 3 months) of supplements. We suggest that mothers' pragmatic attitudes, interacting with certain social, cultural, and economic variables, are important factors influencing their child feeding decisions, especially resisting the use of commercial infant formula, at least in this rural area, and promoting prolonged breastfeeding. PMID:8480239

... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect to Zimbabwe Presidential Documents Other Presidential Documents Notice of February 26, 2010 Continuation of the National Emergency With Respect to Zimbabwe On March 6, 2003, by Executive Order 13288, the President declared a national emergency...

Clement M. Doke's 1929-1930 research on Zimbabwean languages has played a key role in shaping the tribalised and politicised linguistic terrain that characterises modern Zimbabwe. Doke, professor of linguistics at the University of Witwaters-rand, was commissioned in 1929 by the government of Southern Rhodesia (present-day Zimbabwe) to research…

... Congress. (Presidential Sig.) THE WHITE HOUSE, February 26, 2010. [FR Doc. 2010-4805 Filed 3-3-10; 11:15 am... Notice of February 26, 2010--Continuation of the National Emergency With Respect to Zimbabwe #0; #0; #0... the National Emergency With Respect to Zimbabwe On March 6, 2003, by Executive Order 13288,...

Gender discrimination in educational institutions persists, despite the vigorous pursuit of policies and programmes to reduce the varying degrees of gender inequity in Zimbabwe. Zimbabwe is a signatory to international agreements and conventions which promote gender equity with a thrust towards increased access to education for girls and females.…

Zimbabwe faced severe economic challenges that impacted on resource accumulation leading to a decline of quality of teaching and learning in a selected university in Zimbabwe yet the Resource Dependence Theory advocates that organizations are dependent on the environment for resources for survival and achievement of their set objectives. The study…

... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Waiver of Restriction on Assistance to the Central Government of Zimbabwe Pursuant to Section 7031(b)(3) of... Section 7031(b)(1) of the Act with respect to Zimbabwe and I hereby report the waiver of this...

Introduction The Notifiable disease surveillance system (NDSS) was established in Zimbabwe through the Public Health Act. Between January and August 2011, 14 dog bites were treated at Kadoma Hospital. Eighty-six doses of anti-rabies vaccine were dispensed. One suspected rabies case was reported, without epidemiological investigations. The discrepancy may imply under reporting of Notifiable Diseases. The study was conducted to evaluate the NDSS in Sanyati district. Methods A descriptive cross sectional study was conducted. Healthcare workers in selected health facilities in urban, rural, and private and public sector were interviewed using questionnaires. Checklists were used to assess resource availability and guide records review of notification forms. Epi InfoTM was used to generate frequencies, proportions and Chi Square tests at 5% level. Results We recruited 69 participants, from 16 facilities. Twenty six percent recalled at least 9 Notifiable diseases, 72% correctly mentioned the T1 form for notification, 39% correctly mentioned the forms completed in triplicate and 20% knew it was a legal requirement to notify. Ninety six percent of respondents indicated willingness to participate, whilst 41% had ever received feedback. Three out of 16 health facilities had T1 forms. Conclusion NDSS is useful, acceptable, simple, and sensitive. NDSS is threatened by lack of T1 forms, poor feedback and knowledge of health workers on NDSS. T1 forms and guidelines for completing the forms were distributed to all health facilities, public and private sector. On the job training of health workers through tutorials, supervision and feedback was conducted. PMID:25870733

Existing data on health status and health care provision in agricultural labour communities in Zimbabwe indicate that both are poor. In addition, there is evidence that the concentration of capital through increased areas of landholdings, through mechanisation and use of agrochemicals produces a rise in under- and unemployment within the agricultural sector, which increases the risk of ill health. This paper addresses this question in Zimbabwe by examining the nature of developments within the large scale agricultural sector in the last decade, and the consequent effects on employment and income. Rising capital intensity in the private large scale sector is found to be associated with increases in unemployment and underemployment. The impact of this socioeconomic pattern on health is assessed in a longitudinal assessment of 78 permanent labour families and 76 non-permanent (underemployed) labour families in the large scale farming sector. The study shows that while poor social, economic and health conditions exist in all groups, non-permanent labour households suffer greater insecurity of employment and income, poorer health status and lesser participation in sociopolitical structures important for negotiating primary health care gains. PMID:3227374

Schistosoma haematobium and Schistosoma mansoni are prevalent in Zimbabwe to levels that make schistosomiasis a public health problem. Following three national surveys to map the disease prevalence, a national policy on control of schistosomiasis and soil transmitted helminths is being developed. This paper reviews the experiences that Zimbabwe has in the area of schistosomiasis control with a view to influence policy. A case study approach to highlight key experiences and outcomes was adopted. The benefits derived from intersectoral collaboration that led to the development of a model irrigation scheme that incorporates schistosomiasis control measures are highlighted. Similarly, the benefits of using plant molluscicides and fish and duck biological agents (Sargochromis codringtonii and Cairina moschata) are highlighted. Emphasis was also placed on the importance of utilizing locally developed water and sanitation technologies and the critical human resource base in the area of schistosomiasis developed over years. After synthesis of the case studies presented, it was concluded that while there is a need to follow the WHO recommended guidelines for schistosomiasis control it is important to develop a control strategy that is informed by work already done in the country. The importance of having a policy and local guidelines for schistosomiasis control is emphasized. PMID:22655171

In 1992-93 the Department of Physics decided that there was a need for physicists to participate in the industrial development in Zimbabwe. The idea of a Master of Science in Applied Physics programme was conceived. Before designing the programme, a postal survey was conducted to discover the needs of industry particularly in relation to industrial processes. There was a 20% response to our survey with many indicating the area of specialisation required in Zimbabwe. Based on their response, the programme was drawn up and was launched in 1994. The programme has optional specialisations in Industrial Physics, Medical Physics, Laser and Plasma Physics and Environmental Physics. Most of the candidates choose the Industrial Physics option. The programme includes courses in Workshop Practice, Computer Applications Software, Theory of Devices, Computer Interfacing, Instrumentation Physics, Metrology (which includes Quality Control), Digital Signal Processing and Data Communications and Networks, Industrial Applications of Laser and Plasma Physics, Biomedical Instrumentation, and many others. Nearly 30 Zimbabweans and some foreign students have thus far graduated with this degree. On graduation, they have, with relative ease, found employment in indeustry. In two cases, graduates were appointed as Research Officers with firms who set up research divisions specially for them. Many are now teaching at universities and technical colleges throughout the country where they continue to promote an industrial approach to the teaching of physics.

In Zimbabwe, veterinary fences are used to control trypanosomiasis and foot- and-mouth disease, two important diseases that threaten cattle production and beef exports. Wildlife is implicated in both instances and the effects of fences on wildlife conservation and land use are discussed in relation to these two diseases. Advantages and disadvantages related to direct and indirect fence effects are outlined. Although the maintenance of fences for trypanosomiasis control is likely to become obsolete, control of foot- and-mouth disease will rely on fences for the foreseeable future. Most of Zimbabwe's protected wildlife areas are located in marginal agricultural land around the periphery of the country where cattle productivity is low. This land should be excluded from any involvement in the beef export industry rather than attempting its inclusion through cordoning and isolating individual protected areas. Within such land, the need for rigid veterinary restrictions should then disappear and allow more flexible strategies for disease control, including adaptive and imaginative approaches to land-use planning.

A rural development project carried out in Southern Zimbabwe for 5 years was aimed at improving nutrition, combatting diseases, educating villagers about proper hygiene, improving water quality, and assessing the development and nutritional status of children under 5. The community investigated consisted of 10,000 people or 1,439 families with an average of 7 persons per family. The main staple of their diet was maize, and malnutrition was prevalent. Water holes infested with bilharzia were the source of drinking water for both man and animal. The project succeeded in vaccinating 90% of preschool children against whooping cough, diphtheria, tetanus, polio, measles, and tuberculosis. A control district was chosen to compare the developmental data obtained by the Cole Slide Rule Calculator of 229 children under 5 with those of 242 children in the project. Malnutrition was studied in 200 children hospitalized in the children's ward of a district hospital, 1/3 of whom were less than 1 year old. Gastroenteritis, giardiasis and amebiasis were prevalent among them (37%), as were upper respiratory infections (27%), pneumonia (12%), and skin infections (7%). Nonspecific gastroenteritis was found in 86% of children under 2. Most over 2 were severely undernourished. A nutritional rehabilitation village called Hutano Village was established in 1982 to function as a nutritional center, staffed by a full-time health worker and an assistant. In the 1st 9 months of its existence, 114 children were taken in, and the mothers received instruction in vegetable gardening, raising chickens and rabbits, hygiene, and family planning. The average attendance runs to 25 children and 15 to 17 mothers. In spite of successful medical intervention in malnutrition cases, the relapse of children into an undernourished state remains a difficult issue, whose cause lies in inadequate water supply, poor soil, lack of resources, and low family socio-economic status. PMID:6482596

Living with Trees, is an account of the results of a joint World Bank and Zimbabwe Forestry Commission study, in which the status, use and future of Zimbabwes forest, woodland and tree resources are reviewed. The first chapter is, in effect, an executive summary, capturing the major themes of the review and presenting them within a framework which targets the key policy issues affecting forestry in Zimbabwe. The second chapter is a national overview and deals with land, agriculture and economic structural adjustments, which are key policy concerns in Zimbabwe. Within the national context, chapter 2 also reflects on the form and role of the Forestry Commission. This provides a macroeconomic setting for the subsequent chapters which detail social and industrial forestry issues.

There is a health and health care crisis in Zimbabwe which is affecting HIV/AIDS patients, and which is a "direct outcome of the malfeasance of the Mugabe regime and the systematic violation of a wide range of human rights, including...an egregious failure to respect, protect and fulfill the right to health." This is one of the conclusions of a report prepared by Physicians for Human Rights (PHR) following an investigation conducted in Zimbabwe in December 2008. PMID:19610206

Background Traditional medicine has remained as the most affordable and easily accessible source of treatment in the primary healthcare system of resource poor communities in Zimbabwe. The local people have a long history of traditional plant usage for medicinal purposes. Despite the increasing acceptance of traditional medicine in Zimbabwe, this rich indigenous knowledge is not adequately documented. Documentation of plants used as traditional medicines is needed so that the knowledge can be preserved and the utilized plants conserved and used sustainably. The primary objective of this paper is to summarize information on traditional uses of medicinal plants in south-central Zimbabwe, identifying research gaps and suggesting perspectives for future research. Methods This study is based on a review of the literature published in scientific journals, books, reports from national, regional and international organizations, theses, conference papers and other grey materials. Results A total of 93 medicinal plant species representing 41 families and 77 genera are used in south-central Zimbabwe. These plant species are used to treat 18 diseases and disorder categories, with the highest number of species used for gastro-intestinal disorders, followed by sexually transmitted infections, cold, cough and sore throat and gynaecological problems. Shrubs and trees (38% each) were the primary sources of medicinal plants, followed by herbs (21%) and climbers (3%). The therapeutic claims made on medicinal plants documented in south-central Zimbabwe are well supported by literature, with 82.8% of the plant species having similar applications in other regions of Zimbabwe as well as other parts of the world and 89.2% having documented biological and pharmacological properties. Conclusion This study illustrates the importance of traditional medicines in the treatment and management of human diseases and ailments in south-central Zimbabwe. Traditional medicines still play an important

Metasomatism accompanying kimberlite emplacement is a worldwide phenomenon, although infrequently described or recognised. At the Cambrian-aged Murowa and Sese kimberlite clusters located within the Archean Zimbabwe Craton just north of the boundary with the Limpopo Mobile Zone in southern central Zimbabwe, the metasomatism is intense and well exposed and the processes can be readily studied. Dykes, sills and the root zones of pipes are exposed at the current erosion level. Kimberlite lithologies present are hypabyssal macrocrystic kimberlite ("HMK"), HMK breccia, and tuffisitic kimberlite breccia ("TKB") including minor lithic tuffisitic kimberlite breccia ("LTKB"). Country rocks are 2.6 Ga Chibi and Zimbabwe granite batholiths emplaced into 2.6-2.9 Ga or earlier Archean tonalitic gneiss and greenstones. During initial metasomatism, the granites become spotted with green chlorite, needles of alkaline amphiboles (winchite, riebeckite, arfvedsonite) and pyroxenes (aegirine-augite) with minor carbonate and felts of talc. Oligoclase feldspar becomes converted to albite, extensively altered, dusted and reddened with hematite, whereas K-feldspar remains unaffected. The granites become converted to syenite through removal of quartz. More intense metasomatism at Murowa and Sese results in veins of green metasomatite which cut and disrupt the granite. Progressive disruption entrains granite blocks, breaking down the granite still further, spalling off needle-like granite slivers, and so giving rise to LTKB. This process of disruption and entrainment appears to be the manner of initial development of the pipe structure. The chemistry of the metasomatite is intermediate between granite and kimberlite. Compared to granite country rock it has markedly higher Mg, Cr, Ni, CO 2 and H 2O+, higher Ca, Mn, Nb, Sr, P, Fe 3+/Fe 2+ ratio, U, Co, and Cu, approximately equal TiO 2, K 2O, Na 2O, La, Ta, Rb, Zr, Zn and resultant lower SiO 2, Al 2O 3, Ga and Y. The metasomatite Na 2O/K 2O

In this article, the experiences of persons with epilepsy were explored in terms of coping with providing a basis of discussion and training to support groups, particularly in Zimbabwe. Coping mechanisms lay stress upon the individual's control in mastering the disease. It was assumed that a systematic research effort of intra-cultural and cross-cultural sharing of experiences could enhance discussion and training in the support groups. Coping with epilepsy was explored with 37 adults (27 from Zimbabwe and 10 from the Midwest, USA) using open-ended questions in a written questionnaire. Questions aimed to elicit general feelings, experiences and strategies and skills in coping with epilepsy. The questionnaire covered such semantic domains as childhood, education, employment, friendships, relations within the family, and handling of seizures in public places. Coping mechanisms were categorized into two modes, one, adjustment to the disability (palliative), the other adjustment to the environment (problem-solving). In comparing the information between the two groups, some trends can be distinguished which need a larger scale validation. First, palliative skills during childhood in the Zimbabwean group is indicative for early development of personality characteristics and socialization as a result of the illness experiences. A great variety in palliative mechanisms in handling seizures indicates better familiarity with seizures in the Midwestern group. Similarities between the two groups are found in the friendship domain, where palliative coping skills seem to be of no importance, as well as in the domain of intimate relations, where a trend in adherence to medication is observed in both groups. Second, many problem-solving skills are developed in both groups but vary in context. In view of public education and training activities and the enhancement of problem-solving skills, the domain of education for the Zimbabwean group and the domains of friendship with the

BACKGROUND: Economic evaluation of health care has developed into a substantial body of work, and its contribution to medical decision making is increasingly being recognized. OBJECTIVE: The aim of the study was to describe the characteristics and quality of health economic (including pharmacoeconomic) evaluation research studies related to Zimbabwe. METHODS: A review of the literature was conducted to identify published health economic evaluation studies related to Zimbabwe. HEED, PubMed, MEDLINE, HealthSTAR, EconLit, and PsycINFO databases and sociological and dissertation abstracts were used to search for economic analyses. The searches used the following terms alone and in combination: costs, budgets, fee, economics, health, pharmacy, pharmacy services, medicines, drugs, health economics, cost-effectiveness, cost-benefit, cost-minimization, cost utility analysis, and Zimbabwe. Only original applied economic evaluations addressing a health-related topic pertaining to Zimbabwe and published in full were included. Two reviewers independently evaluated and scored each study in the final sample using the data collection form designed for the study. RESULTS: Fifty-nine studies were identified in the database searches, 18 of which were excluded because they were not about Zimbabwe (3 studies) or were not health related (15). Of the 41 remaining studies, 8 were excluded after further review because they were not original research, 6 because they were not economic analyses, and 1 because it was not about Zimbabwe. The final 26 studies appeared in 13 different journals (based mostly [17 (65%)] outside of Zimbabwe). The mean (SD) number of authors of each study was 3.36 (2.13); most of the authors had medical/clinical training. The number of studies peaked between 1994 and 1997. Based on a 10-point scale, with 10 indicating the highest quality, the mean (SD) quality score for all studies was 5.40 (1.56); 8 of the studies (31%) were considered to be of poor quality (score

When ZANU (PF) came to power in 1980, it had promised to establish free and compulsory primary and secondary education for all children in Zimbabwe. The Ministry of Education has achieved remarkable increases in school enrolments, particularly at secondary level. It has also undertaken to allow all pupils to sit the `O' Level examinations after four years of secondary schooling. But by so doing it has encouraged a belief in the importance of academic qualifications and a crisis of expectation among pupils. There are insufficient places for those who wish to continue to Sixth Form (higher secondary) studies, a lack of alternative vocational training, and an inadequate rate of creation of new jobs for school leavers. There seem but three ways out: to cut defence spending in favour of education, to send students abroad for higher training, or to develop new employment and training schemes, perhaps after an imported model.

In September 1993 our expedition visited four strucutres in Zimbabwe that had been selected because of circular outlines or because of unusual aeromagnetic anomalies. The first one, the 1.1-km-diameter Thuli structure was identified as a well-preserved volcanic caldera formed by a series of basaltic, gabbroic, and dioritic instrusions. Preliminary results of magnetic traverses are consistent with the model of a volcanic pipe. The 600- and 800-m-wide Save craters near the Mozambican border closely resemble young, well-preserved impact craters such as the Pretoria Saltpan crater in South Africa. However, detailed geological traverses revealed only volcanic rocks intruded into sandstone forming the sharp rim crests. The Mucheka region is the site of the most prominent aeromagnetic anomaly in Zimbabwe. In the absence of any exposures other than Archean basement, the cause of this anomaly is still unknown. None of the basement rock specimens obtained yielded any evidence for shock metamorphism. In 1985 German geologists reportedly noted a circular structure in the Highbury area on Landsat images. An approximately 25-km-wide circular structure is visible on a SPOT satellite image as well. The regional geological map revealed the presence of a slight elevation near the center of this otherwise flat area. The flat floor of this structure is formed by fertile soils overlying locally exposed Deweras arkose and metadolomites, in turn surrounded by hills of Lomagundi sandstones and slates. Near the geographical center a small hill of sandstone and quartzite was indeed detected. Reconnaissance sampling in 'rim' and 'central uplift' provided several specimens with significant numbers of quartz grains with single or multiple sets of planar deformation features (PDFs). A strongly hematized sample from the 'central uplift' contains shocked quartz and relics of glass.

Incidence of cholera outbreak is a serious issue in underdeveloped and developing countries. In Zimbabwe, after the massive outbreak in 2008-09, cholera cases and deaths are reported every year from some provinces. Substantial number of reported cholera cases in some provinces during and after the epidemic in 2008-09 indicates a plausible presence of seasonality in cholera incidence in those regions. We formulate a compartmental mathematical model with periodic slow-fast transmission rate to study such recurrent occurrences and fitted the model to cumulative cholera cases and deaths for different provinces of Zimbabwe from the beginning of cholera outbreak in 2008-09 to June 2011. Daily and weekly reported cholera incidence data were collected from Zimbabwe epidemiological bulletin, Zimbabwe Daily cholera updates and Office for the Coordination of Humanitarian Affairs Zimbabwe (OCHA, Zimbabwe). For each province, the basic reproduction number ([Formula: see text]) in periodic environment is estimated. To the best of our knowledge, this is probably a pioneering attempt to estimate [Formula: see text] in periodic environment using real-life data set of cholera epidemic for Zimbabwe. Our estimates of [Formula: see text] agree with the previous estimate for some provinces but differ significantly for Bulawayo, Mashonaland West, Manicaland, Matabeleland South and Matabeleland North. Seasonal trend in cholera incidence is observed in Harare, Mashonaland West, Mashonaland East, Manicaland and Matabeleland South. Our result suggests that, slow transmission is a dominating factor for cholera transmission in most of these provinces. Our model projects [Formula: see text] cholera cases and [Formula: see text] cholera deaths during the end of the epidemic in 2008-09 to January 1, 2012. We also determine an optimal cost-effective control strategy among the four government undertaken interventions namely promoting hand-hygiene & clean water distribution, vaccination, treatment

This article discusses perceptions on child participation and responsible citizenship in Zimbabwe's secondary schools. A brief outlook on Zimbabwe's values education is provided followed by a discussion of theoretical frameworks on citizenship and polyarchy and what these mean to the school. The article analyses teacher and student perceptions on…

Background Most agricultural weeds are usually regarded as undesirable and targeted for eradication. However, weeds are useful to human beings as food and traditional medicines. Few studies have been done to document the uses of weeds as traditional vegetables. This study was therefore, done to document indigenous knowledge related to the diversity and use of agricultural weeds as traditional vegetables in Shurugwi District, Zimbabwe, emphasizing their role in food security and livelihoods of the local people. Materials and methods Semi-structured interviews, observation and guided field walks with 147 participants were employed between December 2011 and January 2012 to obtain ethnobotanical data on the use of edible weeds as traditional vegetables. Based on ethnobotanical information provided by the participants, botanical specimens were collected, numbered, pressed and dried for identification. Results A total of 21 edible weeds belonging to 11 families and 15 genera, mostly from Amaranthaceae (19%), Asteraceae and Tiliaceae (14.3%), Capparaceae, Cucurbitaceae and Solanaceae (9.5% each) were identified. Of the documented edible weeds, 52.4% are indigenous while 47.6% are exotic to Zimbabwe; either semi-cultivated or growing naturally as agricultural weeds in farmlands, fallow land and home gardens. Among the main uses of edible weeds were leafy vegetables (81%), followed by edible fruits (19%), edible corms (9.5%), edible flowers and seeds (4.8% each). The most important edible weeds were Cleome gynandra, cited by 93.9% of the participants, Cucumis metuliferus (90.5%), Cucumis anguria (87.8%), Corchorus tridens (50.3%) and Amaranthus hybridus (39.5%). All edible weeds were available during rainy and harvest period with Cleome gynandra, Corchorus tridens, Cucumis anguria, Cucumis metuliferus and Moringa oleifera also available during the dry season, enabling households to obtain food outputs in different times of the year. The importance of edible weeds for local

The challenge of maintaining or improving the quality of rural livelihoods against the increasing threat of climate change (CC) and climate variability (CV) calls for the development of robust and tested systems, tools and procedures for the management of water resources. The research aimed at assessing reservoir operation under variable climate for Rozva Dam, a medium-sized reservoir in Zimbabwe. Rozva Dam is located in the Bikita District of Zimbabwe and has a full supply capacity of 2.8 Mm 3 at a maximum water level of 17.3 m. The research analysed 46 years of rainfall and temperature data to assess climate variability and or change. The CROPWAT model was used to estimate crop water requirements for the adjacent 80 hectare irrigation scheme. The WAFLEX model was applied to simulate the performance of the system under three scenarios: (1) existing demands and operational rules, (2) reduced water availability due to climate change, as predicted by the Ministry of Mines, but with increasing annual demands and (3) climate change situation coupled with change in irrigation technology. The results show a general decreasing linear trend for rainfall although the variance was not statistically significant at p = 0.05. A clearer cyclic pattern was observed for the decadal analysis. An increasing trend in both maximum and minimum temperature was observed although, again, these were not statistically significant with a Spearman’s rank correlation coefficient ( R sp) of below 0.5. The research used rainfall and temperature data as the basis for confirmation climate change and variability in the study area. Analyses show that the area is experiencing more of CV than CC. Modelling results show that the reservoir can satisfy current demands but will fail to cope under the forecasted increase in demand. The conclusions from the research are that the available water resources in the studied system are sufficient to satisfy the current demands. The predicted level of climate

Short birth spacing continues to be a problem in Uganda and Zimbabwe, resulting in negative infant, child, and maternal health outcomes. This study investigates community-level influences on birth spacing outcomes among women aged 15-49 in Uganda and Zimbabwe, using Demographic and Health Surveys conducted in 2011 (Uganda) and 2010-2011 (Zimbabwe). Women living in communities with higher mean maternal age, mean age at marriage, and mean parity were significantly more likely to have longer birth spacing. Women living in communities with higher levels of contraceptive use and low levels of unmet contraceptive need were more likely to have short birth spacing. The significance of community-level demographic and fertility norms, gender norms, economic prosperity, and family planning behaviors demonstrate the broad influence of community variables on birth spacing outcomes. This analysis highlights the importance of moving beyond individual and household-level interventions in order to harness the power of contextual influences on birth spacing. PMID:26103691

In a survey of 1,313 men reporting on 2,465 partnerships recruited at beer halls in Harare, Zimbabwe, 2.5% met a definition of "sugar daddy": men with a non-marital partner at least 10 years younger and under 20 years old, and exchanged cash or goods for sex. Men engaging in intergenerational sex with a teenage woman had similar HIV prevalence, incomes, and condom use as men in other partnerships. Most men (62.3%) had partners 5 or more years younger, with wider age gaps in longer-term relationships. Condom use was less common within married and steady partnerships compared to casual and more common with younger women. The most common form of intergenerational sex, with the widest age gap and lowest condom use, occurs within marriages and steady partnerships. Such "conventional" intergenerational sex may play the pivotal role in sustaining a generalized epidemic across generations and present the most difficult challenge to prevention. PMID:20811939

In the course of a study on the acceptability and feasibility of home-based oral rehydration therapy in rural Zimbabwe, information was collected on attitudes and beliefs about diarrhoea and on action taken in response to an episode of diarrhoea in a child. Diarrhoea was found to be a perceived threat at community and family level and numerous possible causes of diarrhoea were described which were assigned to two broad classes: (1) 'physical' causes, such as a polluted environment, diet and teething and (2) 'social and spiritual' causes such as those associated with a depressed fontanelle. These domains were not, however, mutually exclusive; 76% of the described episodes of diarrhoea were attributed to 'physical' causes, 15% to 'social and spiritual' causes and 8% to a combination of both. Reported utilization rates of the formal health services were unexpectedly high. In contrast, we recorded a low demand for indigenous herbalists (n'angas). Home management was common and comprised the administration of indigenous herbal remedies, of sugar and salt solutions, of over-the-counter drugs or of enemas. These remedies were given on their own or alongside the treatment prescribed by a health worker. A number of variables were examined to assess their influence on health-seeking behaviour: perceived cause and severity of the illness, socio-demographic characteristics of the respondent or child and accessibility of the health services.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6505741

As the AIDS epidemic in Africa assumes major proportions, the need to understand the social context in which heterosexual transmission occurs takes on urgent importance. In this article we explore how the intersection of traditional culture with the colonial legacy and present-day political economy has influenced family structure and sexual relations, and particularly the social position of women. Drawing on Zimbabwe's historical experience, we show how land expropriation, rural impoverishment, and the forcible introduction of male migrant labor fostered new patterns of sexual relations, characterized by multiple partners. Traditional patriarchal values reinterpreted in European law resulted in further subjugation of women as even limited rights to ownership were withdrawn. For many women, sexual relations with men, either within marriage (for the majority) or outside, become inextricably linked to economic and social survival. In this setting, all sexually transmitted diseases became rampant, including genital ulcer, which facilitates transmission of the human immunodeficiency virus (HIV). Intervention programs to halt the spread of AIDS need to take into the account the epidemic's historical roots and social nature. For example, efforts to reduce risk of HIV transmission should seek to expand women's limited options, both technically (e.g., by providing alternatives to condoms) and socially (e.g., by promoting employment). PMID:2004868

Introduction Recent debates on how to achieve an optimal HIV response are dominated by intervention strategies that fail to recognize children's role in the community response to HIV. Whilst formal responses are key to the HIV response, they must recognize and build on indigenous community resources. This study examines adult's perspectives on the role of children in the HIV response in the Matobo District of southern Zimbabwe. Methods Through a mix of individual interviews (n=19) and focus group discussions (n=9), 90 community members who were active in social groups spoke about their community response to HIV. Transcripts were subjected to a thematic analysis and coding to generate key concepts and representations. Findings In the wake of the HIV epidemic, traditional views of children's social value as domestic “helpers” have evolved into them being regarded as capable and competent actors in the care and support of people living with HIV or AIDS, and as integral to household survival. Yet concurrent representations of children with excessive caregiving responsibilities as potentially vulnerable and at risk suggest that there is a limit to the role of children in the HIV response. Conclusion Community volunteers and health staff delivering HIV services need to recognize the “behind the scene” role of children in the HIV response and ensure that children are incorporated into their modus operandi – both as social actors and as individuals in need of support. PMID:23394900

Eighty-eight tracks of large theropod dinosaurs were found in the mid-Jurassic of Zimbabwe. Among the tracks, at least five adjacent trackways are recorded. The adjacent tracks were probably made by animals traveling as a group, given that they are in relatively close succession; that there are three overlapping tracks (among just 23) suggesting reasonably close associations of the animals; that all the tracks are apparently of the same ichnotaxon; that the preservational types of the tracks are similar; and that the tracks are all of animals traveling in one general direction closely associated in time (there are no returning tracks of the same animals or of those of other species; presence of such tracks would be highly probable if the tracks were made over a period of time of even several hours). Nearby, recently discovered giant sauropod tracks, the first in sub-Saharan Africa, indicate a realistic potential of predator/prey interactions between the two groups of dinosaurs. PMID:14676955

This book documents the history, successes, and failures of Save the Children's farmworker program in Zimbabwe, 1981-98. The report explores workers' past and present living and working conditions on commercial farms and describes how the program promoted a progression from workers with a migrant mentality to the building of functional…

Purpose: The purpose of the present study was to investigate agroforestry adoption by smallholder farmers in Gutu District, Zimbabwe. Design/Methodology/Approach: The methodology was based on field data collected through household questionnaires, key informant interviews and direct observations. Findings: Major findings reveal that traditional…

Although Zimbabwe has shown a strong commitment to improving educational access and quality, overall enrollment figures conceal major regional disparities and the lack of education and services in marginalized communities. One neglected sector of the population is the commercial farmworker community, currently comprising about two million hired…

The use of ICTs (information and communication technologies) in Zimbabwe's teacher education colleges is of paramount importance. The teacher trainees have a dual role to play: learning through ICTs and also learning how to teach through them. Interestingly, the rate at which schools have embraced the use of ICTs is unprecedented, but this has not…

The teaching and designing of modules at Zimbabwe Open University (ZOU) is the principal responsibility of a single body of teaching staff, although some authors and content reviewers could be sourced from elsewhere if they are not available in ZOU. This survey, through a case study, examines the involvement of lecturers and staff in the…

Data of reported cases of emotional abuse were collected from six Zimbabwe education offices and a questionnaire was administered to 150 primary school teacher trainees and 300 teachers. The majority of participants believe that shouting, scolding, use of vulgarities, humiliation, and negative labeling of pupils is done by female teachers.…

Reviews experiences of Zimbabwe in implementing education in its first decade of independence, examining cases and effects of educational expansion, and policy dilemmas. New initiatives and a recommitment to current policies are recommended to equalize educational opportunities and provide universal elementary and secondary education. (SLD)

This study provides insight into transition experiences and adjustment of students at a university in Zimbabwe. Research was based on students in the first three semesters of college. Based on prior research college adjustment was conceptualised in this study as involving personal, emotional, social and academic issues. The study was qualitative…

My experience of teaching the Rhodes University/Speciss College Environmental Education Course in Zimbabwe alerted me to a tension between the industry course participants who largely (although not entirely) wanted a skills/vocational training orientation and the course curriculum developers, who wanted a critical/theoretical/praxis-based…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide is a two-part unit…

A study on investigating the issues of quality associated with cross-border higher education was carried out using the case study approach focusing on Zimbabwe. The methodology involved document analysis of the cases of regulation and accreditation of cross-border higher education providers and assessment of qualifications acquired from foreign…

In Zimbabwe, there have been some debates on democratisation and decentralisation, which led to the development of policies meant to increase teacher participation in decision-making in schools. However, despite these developments, teacher participation in decision-making in Zimbabwean schools is regarded as insignificant. Teachers work closely…

This paper briefly examines the historical background to political independence in African nations, highlighting the control of the colonial masters on those nations. The "hangovers" describes how early colonial control has had serious influence on the development of social studies curriculum in Zimbabwe. The paper concludes by narrating the…

This research was undertaken to investigate the issue of how to maximise or make efficient use of bandwidth. In particular, the research sought to find out about what universities in Zimbabwe are doing to manage their bandwidth. It was, therefore, appropriate to survey a sample of five universities and to catalogue their experiences. Results show…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide is a four-part unit…

This paper is based on research on the role of UK qualifications suppliers in providing qualifications and accreditation in Sri Lanka and Zimbabwe in the context of rather different engagements with liberalisation, structural adjustment and globalisation. Sri Lanka's economic liberalisation and growth since the late 1970s has had a "de facto"…

The study sought to investigate curriculum issues, teaching and learning for sustainable development in secondary schools in Zimbabwe. Education for sustainable development (ESD) aims at changing the approach to education by integrating principles, values, practices and needs in all forms of learning. Literature has documented the importance of…

Does agricultural input aid always lead to favourable food security outcomes? This paper describes Zimbabwe's agricultural recovery program for the 2003/2004 farming season and draws some lessons that can be used in the designing and implementation of future programs. Input aid was found to be most beneficial if it is packaged together with other…

Educational discourse, like other fields, is not neutral. Through policy documents it has ideological functions of transmitting dominant cultures and serving certain sectional interest groups. In Zimbabwe 1998 was characterized by radical political discontent as witnessed by a rise in student activism and the formation of the main political…

This work contributes to the philosophical debate on the normative dimension of postcolonial education in Zimbabwe. The work is a reaction to revelations made by the Commission of Inquiry into Education and Training of 1999 and its concomitant recommendations. Among its many observations, the Commission noted that there was a worrisome development…

The purpose of this study was to investigate the challenges facing Open and Distance Learning students at the Zimbabwe Open University (ZOU). The study was conducted at ZOU Masvingo Regional Campus. The study employed both qualitative and quantitative approaches. The main data collection techniques were questionnaires and structured interviews,…

The study seeks to establish scientific evidence of the factors affecting academic performance for first year accounting students using four selected courses at the University of Zimbabwe. It uses Ordinary Least Squares method to analyse the influence of personal and family background on performance. The findings show that variables age gender,…

This paper reports on a study of the implementation of science teacher education through virtual and open distance learning in the Mashonaland Central Province, Zimbabwe. The study provides insight into challenges faced by students and lecturers on inception of the program at four centres. Data was collected from completed evaluation survey forms…

Zimbabwe's Education Ministry recommended the teaching of African Traditional Religion in recognition of its multi-religious society. This study sought to establish the extent to which African Traditional Religion is taught in primary schools, the challenges faced by teachers, and opportunities for promoting its teaching. A descriptive survey…

In the context of continuous innovations in information and communication technology (ICT) and its impact on higher education, this study explored the integration of instructional technology (IT) by university lecturers in pre-service secondary school teacher education programs in Zimbabwe. Specifically, the study examined how lecturers integrate…

Globally, mentoring has been recognized as one of the effective approaches in professional training and development of teachers. Most importantly, in Zimbabwe, mentoring has been largely adopted as one of the Teaching Practice strategies by teacher training colleges and schools. Good quality mentoring in schools makes an important contribution to…

Students with Hearing Impairment (HI) are experiencing learning problems in most institutions of Higher Learning in Zimbabwe. Access to colleges and universities is limited and where they are accepted, there are no facilities to cater for their needs, hence there is need to develop learning materials that enable these students to learn effectively…

Sorghum rust (Puccinia purpurea) is a foliar disease that affects sorghum productivity worldwide. The use of resistant sources is the most effective and stable way to control the disease. In this study, 68 sorghum accessions from the Zimbabwe collection maintained by the USDA-ARS, Plant Genetic Re...

The USDA-ARS National Plant Germplasm System maintains a Zimbabwe sorghum collection of 1,235 accessions from different provinces. This germplasm has not been extensively employed in U.S. breeding programs due to the lack of phenotypic and genetic characterization. Therefore, 68 accessions from th...

This article raises some inconsistencies observed in attachment teaching practice in Zimbabwe. The argument made is that these inconsistencies are caused by the different philosophical approaches informing attachment teaching practice and its delivery, which is largely visible in teaching practice supervision. The discussion shows that while…

The attraction and retention of teachers in Zimbabwe is a problem not only unique to Zimbabwean schools, but all over the world. The problem is more pronounced in rural areas where resources are scarce, hence the tendency to repel teachers. Although the problem of teacher turnover is real, there are teachers who have remained in the profession for…

Discusses the inadequacies of modernization theory of development and of research informed by modernization theory, in explaining the continuing exploitation and discrimination experienced by women in Zimbabwe. A historical overview of the state's perpetuating and reproducing patriarchy is presented that reveals the use of legislation and…

This is a report of whole-genome sequences of a Brucella abortus strain and two Brucella suis strains isolated from bovine in Zimbabwe. These strains were selected based on their origin and data obtained when using multiplex PCR assays, then sequenced using next-generation sequencing technologies. PMID:25342680

Although a voluminous amount of literature addresses language-in-education policy in Africa, one area in which the literature remains sparse is the role of minority languages in education. This article presents an overview of complex issues regarding the hegemony claims of different minority language groups in Zimbabwe. Given the relatively small…

The aim of the study was to investigate the teaching of fractions by Ordinary level mathematics teachers at Radcliff high school in Zimbabwe. The main objective of the study was to establish how teachers teach the concept of fraction and to find out why they teach in the manner they do. A case study research design was used and purposive sampling…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide presents activities…

This case study looked at 76 randomly selected preservice science teachers from Mbire and Guruve districts who were learning at the Mushumbi Centre in Zimbabwe and assessed their motivations for enrolling under the Bindura University of Science Education (BUSE)'s Virtual and Open Distance Learning (VODL) programme. It also looked at the challenges…

This article draws from my current research on the challenges that the concept "citizenship" brings to postcolonial Africa. The article takes Zimbabwe as a case study with the view to interrogate how the decade-long crisis has been obfuscated by the elites' manipulation of the education system which has left it redundant for envisioning both…

This paper reflects on the key actors in education policy making in Zimbabwe. It looks at the contextual complexities that characterized policy-making in this country to make sense of the contestations that the state had to confront and accommodate. The policy network approach is employed as an analytical framework to clarify how, in particular…

This article considers the ways in which educators and learning societies in Zambia and Zimbabwe have had to struggle to create independent, democratic and critical curricula in difficult circumstances over the last 50 years in the context of historical shifts in power, a declining British Empire and the re-emergence of reactionary forces at a…

The beginning of the 1980s saw the birth of Zimbabwe as a result of a protracted liberation war. It coincided with global interest in primary health care, the concept of universal primary school education and, unfortunately, moves towards economic stabilization and structural adjustment programmes. Economic structural adjustment was adopted by several sub Saharan African countries with dire consequences for the poor and vulnerable. Zimbabwe's commitment to social justice and to equitable distribution of resources demonstrated a practical move away from the culture of rhetoric so characteristic of many governments and non-governmental organisations and agencies. This commitment has been translated into impressive improvements in health and education. Current evidence shows that education has had a positive impact on health and related areas like contraceptive use, child mortality and the nutrition status of children. Conversely nutrition and health conditions among school children are important determinants of educational outcomes. Hitherto Zimbabwe's economy has been sufficiently strong to avoid excessive dependence on the International Monetary Fund, the World Bank and other foreign financial institutions. Unfortunately, however, the current economic recession together with economic structural adjustment programmes are beginning to have a negative impact on health and education. Will true synergism between health and education weather these structural problems? It seems that the people and government of Zimbabwe have the capacity and resolve to weather such a storm. PMID:1469676

The study sought to provide an understanding of the quality assurance challenges and opportunities faced by private universities in Zimbabwe. The study analyzed the factors determining provision of quality higher education in private universities and the resultant effects of failing to achieve the minimum acceptable standards. The author employed…

The Mana Pools sedimentary basin lies within the Zambezi mobile belt in northern Zimbabwe. New and preexisting magnetotelluric data and the available seismic reflection data are used to constrain the basin structure and the depth to the electrical basement. Long-period magnetotelluric (LMT) data were collected at five stations along a 60 km north-south profile across the Mana Pools basin and onto the southern escarpment. These data augment an existing audiofrequency (AMT) data set from 11 sites in the same area. The subsurface apparent resistivities measured at periods sampling the basin are very low (a few Ωm). After processing both data sets, the estimated impedance tensor is decomposed, showing that the resistivity structure of the Mana Pools basin can be modeled two dimensionally. The ρ+ algorithm is used to show that there is no systematic offset in magnitude between the AMT and LMT data sets before they are combined. Minimum structure resistivity models of the Mana Pools basin compare well with the information from reflection seismic data and support its previous description as a half graben basin of ˜7 km depth. The excellent conductor in the Mana Pools basin is quite different to those seen elsewhere in the orogenic belt in that it is a feature of the sedimentary fill rather than the basement. The resistivity of the basement is low but no localized good conductor is observed; these low resistivities may result from a high degree of either chemical or tectonic alteration to the underlying rocks due to metamorphic processes and tectonic disruption during rift formation.

OBJECTIVE: To compare alternative methods to vital registration systems for estimating adult mortality, and describe patterns of mortality in Manicaland, Zimbabwe, which has been severely affected by HIV. METHODS: We compared estimates of adult mortality from (1) a single question on household mortality, (2) repeated household censuses, and (3) an adult cohort study with linked HIV testing from Manicaland, with a mathematical model fitted to local age-specific HIV prevalence (1998 -2000). FINDINGS: The crude death rate from the single question (29 per 1000 person-years) was roughly consistent with that from the mathematical model (22 -25 per 1000 person-years), but much higher than that from the household censuses (12 per 1000 person-years). Adult mortality in the household censuses (males 0.65; females 0.51) was lower than in the cohort study (males 0.77; females 0.57), while mathematical models gave a much higher estimate, especially for females (males 0.80 -0.83; females 0.75 -0.80). The population attributable fraction of adult deaths due to HIV was 0.61 for men and 0.70 for women, with life expectancy estimated to be 34.3 years for males and 38.2 years for females. CONCLUSION: Each method for estimating adult mortality had limitations in terms of loss to follow-up (cohort study), under-ascertainment (household censuses), transparency of underlying processes (single question), and sensitivity to parameterization (mathematical model). However, these analyses make clear the advantages of longitudinal cohort data, which provide more complete ascertainment than household censuses, highlight possible inaccuracies in model assumptions, and allow direct quantification of the impact of HIV. PMID:16583077

Background To better understand trends in the burden of malaria and their temporal relationship to control activities, a survey was conducted to assess reported cases of malaria and malaria control activities in Mutasa District, Zimbabwe. Methods Data on reported malaria cases were abstracted from available records at all three district hospitals, three rural hospitals and 25 rural health clinics in Mutasa District from 2003 to 2011. Results Malaria control interventions were scaled up through the support of the Roll Back Malaria Partnership, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and The President’s Malaria Initiative. The recommended first-line treatment regimen changed from chloroquine or a combination of chloroquine plus sulphadoxine/pyrimethamine to artemisinin-based combination therapy, the latter adopted by 70%, 95% and 100% of health clinics by 2008, 2009 and 2010, respectively. Diagnostic capacity improved, with rapid diagnostic tests (RDTs) available in all health clinics by 2008. Vector control consisted of indoor residual spraying and distribution of long-lasting insecticidal nets. The number of reported malaria cases initially increased from levels in 2003 to a peak in 2008 but then declined 39% from 2008 to 2010. The proportion of suspected cases of malaria in older children and adults remained high, ranging from 75% to 80%. From 2008 to 2010, the number of RDT positive cases of malaria decreased 35% but the decrease was greater for children younger than five years of age (60%) compared to older children and adults (26%). Conclusions The burden of malaria in Mutasa District decreased following the scale up of malaria control interventions. However, the persistent high number of cases in older children and adults highlights the need for strategies to identify locally effective control measures that target all age groups. PMID:23815862

This exploratory study describes the nature and magnitude of the problem of health referrals, health-seeking behavior, perceptions, and knowledge at the district level in Zimbabwe. Data were obtained from focus groups with 159 persons in Tsholotsho and 132 persons in Murewa; from discussions with health personnel from the 6 health centers in Murewa and the 2 rural hospitals in Tsholotsho; and from records among a systematic sample of 400 new outpatients during October 1993 and March 1994 in Murewa district. Findings indicate that 71.8% in outpatient departments at Murewa Hospital had no access to a health center. 24.3% by-passed the health center for treatment at the hospital. 3.8% were referred by health centers. The absolute number of referrals did not change during 1991-93. However, the number directly accessing services from outside the district rose. Focus group participants reported their intention to use the nearest clinic for an illness. In Tsholotsho, people initially used the village community worker/headman. If illness was perceived as serious, patients would go to a hospital. For minor illness, people used traditional herbal remedies. If illness did not change after remedies, the clinic was consulted. Some illnesses were perceived as outside the realm of medicine. Most distinguished between a health center and a hospital, but were unaware of the important, superior functions of the health center. Most did not understand the logic behind the referral system, but appreciated referrals and not the cost of hospital treatment or transportation. The community was unaware of Ward Health Teams. Many did not understand the new fee policy introduced in 1994. PMID:9810401

Malaria is a global public health problem, with about 3.2 billion people at risk of infection. The populations at risk mainly reside in Africa, Asia and America, with African populations accounting for the largest burden of the disease. In 2013, close to 198 million malaria cases were reported, leading to 584,000 deaths. Much (90 %) of the mortality rates were recorded from the World Health Organization (WHO) database in the African region and 78 % of these occurred in children under the age of five. In Zimbabwe, approximately half of the population is at risk of infection with malaria.Insecticide residual spraying (IRS) has been documented as an effective way to control malaria and has been adopted globally by the WHO and national governments. However, both insecticide resistance and climate change threaten to reverse the progress made by IRS in malaria control. Resistance has been reported in all four classes of insecticides approved by the WHO for vector control intervention. Variability of environmental temperature is suspected to complicate the situation through alteration in the genetic structure, and enzyme and protein profiles of mosquitoes. In Zimbabwe, little research has been done on the interaction between climate change, temperature variability and insecticide resistance in malarial mosquitoes over time. Such information is important for informing policies on insecticide selection for IRS.We reviewed literature on insecticide sensitivity among malarial mosquitoes in Zimbabwe from 1972 to 2014. International peer-reviewed articles on insecticide sensitivity in Zimbabwe, published in English in this time period, were searched using MEDLINE® (PubMed), Google Scholar, Google and grey literature. Eight publications were eligible for the present study, with one of the articles being a review paper. Six articles covered insecticide resistance, while the other two articles, published in 2000, were about the absence of resistance. Contradicting resistance

This paper explores the nature and characteristics of lone motherhood in Zimbabwe. We argue that endogenous and exogenous forces associated with failing economies and gendered public policy structures, practices, and initiatives exacerbated by HIV/AIDS and intermittent droughts have worsened national poverty with much more devastation experienced by lone mothers and their children. Using vignettes of lone parents drawn from Zimbabwe, this paper extends the perspectives on lone motherhood to show the extent of poverty experienced by lone mothers as well as the varied formations and structures of lone parenthood. The vignettes highlight the socioeconomic concerns for these families regarding inadequate income, lack of access to employment, lack of housing, and problematic governmental policies that affect the well-being of lone mothers and their families. We conclude with a discussion of the role of social policy in managing the context in which lone mothers and their families must live and function. PMID:19229781

This paper reports the discovery of annual tree ring formation in two species of trees in Zimbabwe and describes their paleoclimatic reconstruction potential. Due to the strong influence of El Nino-Southern Oscillation on the climate and crop yields of Zimbabwe and surrenting areas, and the rarity of annual tree ring chronologies in the tropics, the discovery of climatically sensitive growth rings is extremely significant. In particular, the Pterocarpus angolensis shows a strong correlation between the derived tree ring chronology and regional rainfall amounts. Based on sampling at the Sikumi Forest, it is speculated that P. angolensis may routinely achieve over 200 years in age. Four lines of evidence are identified which indicate that the semi-ring porous growth bands in P. angolensis are exactly annual growth rings. 18 refs., 3 figs.

Few studies have investigated a cultural group's corporeal experiences in both its country of origin and a host, Western country using the same methodology. To overcome this dearth in the literature, the present study examined body image among 140 women in Harare, Zimbabwe, and an age-matched sample of 138 Zimbabwean migrants in Britain. Participants completed measures of actual-ideal weight discrepancy, body appreciation, and lifetime exposure to Western and Zimbabwean media. Preliminary analyses showed that there were no significant differences in body mass index between the two groups. Further analyses showed that Zimbabwean women in Britain had significantly greater weight discrepancy and lower body appreciation than their counterparts in Zimbabwe. In addition, weight discrepancy and body appreciation among both samples were significantly associated with exposure to Western media, but not Zimbabwean media. These findings support the contention that transcultural migration may place individuals at risk for symptoms of negative body image. PMID:22717762

In Zimbabwe, unpredictable conditions associated with structural and institutional factors exacerbated the combined effects of structural violence, economic and political instability, and climate change in the mid 2000s, contributing to widespread food insecurity. Drought, food shortages, and government settlement policy affecting both rural and urban populations has yielded a national human rights crisis. Drawing on ethnographic research conducted in Mutare, southeast Zimbabwe, in 2005-2006, the authors illustrate the flow-on effects of drought and government policy on the livelihoods of households already suffering as a result of the social impacts of AIDS, and how people in a regional city responded to these factors, defining and meeting their basic food needs in diverse ways. PMID:22455860

Conventional wisdom, as reflected in reports by the World Bank and the Whitsun Foundation, maintains that control of population growth is the key strategy for stimulating socioeconomic development and ending widespread poverty. The Witsun Foundation has criticized the Government of Zimbabwe for failing to include specific policies for population control in its National Transitional Development Plan. the report further expressed alarm about future availability of land to contain Zimbabwe's growing population. Communal areas are designed for a maximum of 325,000 families yet presently contain 700-800,000 families. This Malthusian, deterministic emphasis on population growth as the source of social ills ignores the broader, complex set of socioeconomic, historical, and political factors that determine material life. Any analysis of population that fails to consider the class structure of society, the type of division of labor, and forms of property and production can produce only meaningless abstractions. For example, consideration of crowding in communal areas must include consideration of inequitable patterns of land ownership in sub-Saharan Africa. Unemployment must be viewed within the context of a capitalist economic structure that relies on an industrial reserve army of labor to ensure acceptance of low wages and labor-intensive conditions. While it is accepted that population growth is creating specific and real problems in Zimbabwe and other African countries, these problems could be ameliorated by land reform and restructuring of the export-oriented colonial economies. Similarly, birth control should not be promoted as the solution to social problems, yet family planning services should be available to raise the status of women. Literacy, agrarian reform, agricultural modernization, and industrialization campaigns free from the dominance of Western capitalism represent the true solutions to Zimbabwe's problems. PMID:12342943

In February 2009, the World Health Organization (WHO) reported that the cholera epidemic in Zimbabwe had claimed 3,300 lives and infected 66,000 people--greater than the toll of that disease in the whole of Africa in most years. How is it possible that a disease such as cholera can have such a devastating effect in modern times? How should one…

In 1995, a new species of Trichinella (Trichinella zimbabwensis) was discovered in farmed Nile crocodiles (Crocodylus niloticus) in Zimbabwe, where the mode of transmission was the consumption of the meat of slaughtered crocodiles, used as feed. To determine whether T. zimbabwensis affects poikilotherm vertebrates in the wild, monitor lizards (Varanus niloticus) and Nile crocodiles were collected in Zimbabwe and Mozambique. In 5 (17.6%) of the 28 monitor lizards from Zimbabwe, T. zimbabwensis larvae were identified. For the wild Nile crocodiles from Mozambique, species-level identification was not possible, yet immunohistochemical analysis revealed that 8 (20%) of the 40 animals harboured non-encapsulated Trichinella sp. larvae, which probably belonged to T. zimbabwensis. This is the first report of T. zimbabwensis in wild reptiles, and the findings are consistent with reports that vertebrates with scavenger and cannibalistic behaviour are the most important hosts of Trichinella spp. The wide distribution of monitor lizards and crocodiles in Africa and the development of national crocodile breeding programs in many African countries should be taken into consideration when evaluating the risk of transmission of this parasite to mammals, including humans. PMID:16982152

Zimbabwe embarked on a water sector reform programme in 1995. Two goals of the water reform were to broaden women’s access to water and to enhance their participation in water management. This paper analyses how gender was addressed at the national and institutional levels and in the water reform process, paying particular attention on how strategic gender needs were addressed in the process and the resultant policies and Acts. The results show that although the government of Zimbabwe has made considerable progress in mainstreaming gender at the ministerial level, departments which are involved in the actual implementation of water programmes do not have clear gender policies. Therefore although gender equity was one of the main goals of the water reform, most poor women and men were not involved in the consultations. Consequently neither the new Water Act nor the Zimbabwe National Water Authority (ZINWA) Act addresses gender in explicit terms. Strategic gender needs are not addressed at all. It is recommended that all institutions in the water sector, including NGOs, should have clear gender policies, include a gender perspective in their organisation culture and practices and address strategic gender needs through training, education and supporting productive use of water.

This review outlines and discusses the new challenges in malaria control and prospects for its elimination in Mutare and Mutasa Districts, Zimbabwe. The burden of malaria has declined significantly over the past 5 years in most regions in Zimbabwe, including Mutare and Mutasa Districts. The nationwide malaria reduction has been primarily linked to scaled-up vector control interventions and early diagnosis and treatment with effective anti-malarial medicines. The successes recorded have prompted Zimbabwe's National Malaria Control Programme to commit to a global health agenda of eliminating malaria in all districts in the country. However, despite the decline in malaria burden in Mutare and Mutasa Districts, there is clear evidence of new challenges, including changes in vector behaviour, resistance to insecticides and anti-malarial medicines, invasion of new areas by vectors, vectors in various combination of sympatry, changes in vector proportions, outdoor malaria transmission, climate change and lack of meticulousness of spray operators. These new challenges are likely to retard the shift from malaria control to elimination in Mutare and Mutasa Districts. PMID:27411705

Using detailed field study observations of the side-striped jackal (Canis adustus) and a simple stochastic model of the transmission dynamics of the virus and host demography, we discuss the epidemiology of rabies virus infection in the jackal population of Zimbabwe. Of the two jackal species in Zimbabwe, the other being the black-backed jackal (Canis mesomelas), the bulk of notified rabies cases are in side-striped jackals. Specifically, we show that the side-striped jackal population itself does not seem able to support rabies infection endemically, i.e. without frequent reintroduction from outside sources of infection. We argue that this is probably because the overall average jackal population density is too low to maintain the chain of infection. This study suggests that the disease is regularly introduced to jackals by rabid dogs from populations associated with human settlements. Given the rapidly rising dog population in Zimbabwe, estimates are derived of the future incidence of jackal rabies based on different dog-vaccination scenarios. PMID:9684293

The AIDS epidemic has contributed to a drastic increase in the number of orphans in Zimbabwe. Orphans (whether orphaned by AIDS or other causes) have been shown to have economic and educational disadvantages as well as poor reproductive health outcomes. We recruited a convenience sample of 200 girls in a peri-urban area of Zimbabwe to examine the impact of orphan status (compared to non-orphans) on household composition, education, risk behaviour, pregnancy and prevalent HIV and HSV-2 infection. In our population, maternal orphans were more likely to be in households headed by themselves or a sibling, to be sexually active, to have had an STI, to have been pregnant and to be infected with HIV. Paternal orphans were more likely to have ever been homeless and to be out of school. Our findings suggest that maternal care and support is important for HIV prevention. This finding corroborates previous research in Zimbabwe and has implications for intervention strategies among orphan girls. PMID:18293132

The ZVITAMBO trial recruited 14,110 mother–infant pairs to a randomized controlled trial of vitamin A between 1997 and 2000, before the availability of antiretroviral therapy for HIV prophylaxis or treatment in Zimbabwe. The HIV status of mothers and infants was well characterized through 1–2 years of follow-up, leading to the largest cohort to date of HIV-exposed uninfected (HEU) infants (n = 3135), with a suitable comparison group of HIV-unexposed infants (n = 9510). Here, we draw on 10 years of published findings from the ZVITAMBO trial. HEU infants had increased morbidity compared to HIV-unexposed infants, with 50% more hospitalizations in the neonatal period and 30% more sick clinic visits during infancy, particularly for skin infections, lower respiratory tract infections, and oral thrush. HEU children had 3.9-fold and 2.0-fold higher mortality than HIV-unexposed children during the first and second years of life, respectively, most commonly due to acute respiratory infections, diarrhea/dysentery, malnutrition, sepsis, and meningitis. Infant morbidity and mortality were strongly related to maternal HIV disease severity, and increased morbidity remained until maternal CD4 counts were >800 cells/μL. HEU infants were more likely to be premature and small-for-gestational age than HIV-unexposed infants, and had more postnatal growth failure. Here, we propose a conceptual framework to explain the increased risk of infectious morbidity, mortality, and growth failure among HEU infants, hypothesizing that immune activation and inflammation are key drivers of both infection susceptibility and growth failure. Future studies should further dissect the causes of infection susceptibility and growth failure and determine the impact of ART and cotrimoxazole on outcomes of this vulnerable group of infants in the current era. PMID:27375613

The ZVITAMBO trial recruited 14,110 mother-infant pairs to a randomized controlled trial of vitamin A between 1997 and 2000, before the availability of antiretroviral therapy for HIV prophylaxis or treatment in Zimbabwe. The HIV status of mothers and infants was well characterized through 1-2 years of follow-up, leading to the largest cohort to date of HIV-exposed uninfected (HEU) infants (n = 3135), with a suitable comparison group of HIV-unexposed infants (n = 9510). Here, we draw on 10 years of published findings from the ZVITAMBO trial. HEU infants had increased morbidity compared to HIV-unexposed infants, with 50% more hospitalizations in the neonatal period and 30% more sick clinic visits during infancy, particularly for skin infections, lower respiratory tract infections, and oral thrush. HEU children had 3.9-fold and 2.0-fold higher mortality than HIV-unexposed children during the first and second years of life, respectively, most commonly due to acute respiratory infections, diarrhea/dysentery, malnutrition, sepsis, and meningitis. Infant morbidity and mortality were strongly related to maternal HIV disease severity, and increased morbidity remained until maternal CD4 counts were >800 cells/μL. HEU infants were more likely to be premature and small-for-gestational age than HIV-unexposed infants, and had more postnatal growth failure. Here, we propose a conceptual framework to explain the increased risk of infectious morbidity, mortality, and growth failure among HEU infants, hypothesizing that immune activation and inflammation are key drivers of both infection susceptibility and growth failure. Future studies should further dissect the causes of infection susceptibility and growth failure and determine the impact of ART and cotrimoxazole on outcomes of this vulnerable group of infants in the current era. PMID:27375613

To evaluate the Adult Literacy Organization of Zimbabwe (ALOZ), an organization whose aim is to achieve universal literacy in Zimbabwe, a study interviewed officials at ALOZ, the United States Agency for International Development (USAID), and other institutions involved in literacy development; reviewed relevant literature and documents;…

In Zimbabwe, the discourse on access and quality in education has been a raging one since the colonial days of bottlenecks and outright discrimination against black Zimbabweans in education. The doors to education were declared open to all at independence in 1980 with the new Zimbabwe government's enunciated policy of education for all. It is an…

This article examines studies done on the use of the CA locally, in addition to insights from studies done abroad, as well as critically examining the nature of the CA and the language situation in Zimbabwe, to identify and discuss the main challenges associated with the use of this approach to the teaching of ESL in Zimbabwe and its implications…

Part of the series "Early Childhood Development: Practice and Reflections," this report details the Kushanda Project, an early childhood education program in Zimbabwe. The Kushanda Project is a 16-person organization that has helped parents in rural Zimbabwe communities to understand the value of early childhood education and development. Since…

Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician's ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols. PMID

Introduction Use of herbal remedies among HIV-infected individuals in Africa increased in the past decade, mainly due to traditional beliefs and at times inconsistent access to antiretroviral drugs. In Zimbabwe, accessibility and availability of antiretroviral drugs has increased in recent years; however, the use of herbal remedies remains high. This study was conducted to determine the impact of concomitant use of herbal remedies with antiretroviral drugs on adverse events and on quality of life. Methodology A convenient sample of HIV positive patients at Parirenyatwa group of hospitals' Family Care Clinic (Harare, Zimbabwe) was enrolled. A questionnaire was used to collect data on the adverse event experiences of the patients using herbal remedies for their HIV, as well as the types of herbal remedy used. Quality of life index was measured using an HIV/AIDS targeted quality of life (HAT-QOL) tool developed by the World Health Organization. Results Abdominal pain (odds ratio = 2.7, p-value = 0.01) and rash (odds ratio = 2.5, p-value = 0.02) had significant associations with using herbal remedies during antiretroviral therapy. Improved quality of life index was not significantly associated with herbal remedy use during antiretroviral therapy. Conclusions There is evidence to suggest that some traditional herbal remedies used in Zimbabwe may increase incidence of certain types of adverse events when used in combination with antiretroviral drugs. Use of herbal drugs in combination with antiretroviral therapy does not significantly improve quality of life index in comparison to antiretroviral drug use only. PMID:21330740

... Division of Geriatrics and Clinical Gerontology Division of Neuroscience FAQs Funding Opportunities Intramural Research Program Office of ... have to spend the night in the hospital. Learning more about what to expect and about people ...

It remains an open question whether hospital spending on fundraising efforts to garner philanthropy is a good use of funds. Research and industry reports provide conflicting results. We describe the accounting and data challenges in analysis of hospital philanthropy, which include measurement of donations, measurement of fundraising expenses, and finding the relationships among organizations where these cash flows occur. With these challenges, finding conflicting results is not a surprise. PMID:23614267

Introduction Zimbabwe has a high human immunodeficiency virus (HIV) burden. It is therefore important to scale up HIV-testing and counseling (HTC) as a gateway to HIV prevention, treatment and care. Objective To determine factors associated with being HIV-tested among adult men and women in Zimbabwe. Methods Secondary analysis was done using data from 7,313 women and 6,584 men who completed interviewer-administered questionnaires and provided blood specimens for HIV testing during the Zimbabwe Demographic and Health Survey (ZDHS) 2010–11. Factors associated with ever being HIV-tested were determined using multivariate logistic regression. Results HIV-testing was higher among women compared to men (61% versus 39%). HIV-infected respondents were more likely to be tested compared to those who were HIV-negative for both men [adjusted odds ratio (AOR) = 1.53; 95% confidence interval (CI) (1.27–1.84)] and women [AOR = 1.42; 95% CI (1.20–1.69)]. However, only 55% and 74% of these HIV-infected men and women respectively had ever been tested. Among women, visiting antenatal care (ANC) [AOR = 5.48, 95% CI (4.08–7.36)] was the most significant predictor of being tested whilst a novel finding for men was higher odds of testing among those reporting a sexually transmitted infection (STI) in the past 12 months [AOR = 1.86, 95%CI (1.26–2.74)]. Among men, the odds of ever being tested increased with age ≥20 years, particularly those 45–49 years [AOR = 4.21; 95% CI (2.74–6.48)] whilst for women testing was highest among those aged 25–29 years [AOR = 2.01; 95% CI (1.63–2.48)]. Other significant factors for both sexes were increasing education level, higher wealth status and currently/formerly being in union. Conclusions There remains a high proportion of undiagnosed HIV-infected persons and hence there is a need for innovative strategies aimed at increasing HIV-testing, particularly for men and in lower-income and lower-educated populations. Promotion of STI

The aim of this study was to identify and determine the genetic diversity of Fasciola species in cattle from Zimbabwe, the KwaZulu-Natal and Mpumalanga provinces of South Africa and selected wildlife hosts from Zimbabwe. This was based on analysis of DNA sequences of the nuclear ribosomal internal transcribed spacer (ITS1 and 2) and mitochondrial cytochrome oxidase 1 (CO1) regions. The sample of 120 flukes was collected from livers of 57 cattle at 4 abattoirs in Zimbabwe and 47 cattle at 6 abattoirs in South Africa; it also included three alcohol-preserved duiker, antelope and eland samples from Zimbabwe. Aligned sequences (ITS 506 base pairs and CO1 381 base pairs) were analyzed by neighbour-joining, maximum parsimony and Bayesian inference methods. Phylogenetic trees revealed the presence of Fasciola gigantica in cattle from Zimbabwe and F. gigantica and Fasciola hepatica in the samples from South Africa. F. hepatica was more prevalent (64%) in South Africa than F. gigantica. In Zimbabwe, F. gigantica was present in 99% of the samples; F. hepatica was found in only one cattle sample, an antelope (Hippotragus niger) and a duiker (Sylvicapra grimmia). This is the first molecular confirmation of the identity Fasciola species in Zimbabwe and South Africa. Knowledge on the identity and distribution of these liver flukes at molecular level will allow disease surveillance and control in the studied areas. PMID:26476916

When the Laennec Hospital of Paris closed, after 366 years of activities for the patients, the articles about the circumstances of the foundation and the main stapes of the institution which became an very famous university hospital it present the available information of the history of the apothecaries, of the "gagnants-maitrise", pharmacists and the pharmacy's interns who succeeded themselves to create and dispense the medicaments necessary to the patients hospitalized or welcomed in ambulatory. It describes the evolution of the places, of the material, of forms, of the organization, of the medicaments and of the missions of what became the Pharmacy department after the recent individualization of the biological analysis in the biochemistry. PMID:11625687

Background: The PrePex device has proven to be safe for voluntary medical male circumcision (VMMC) in adults in several African countries. Costing studies were conducted as part of a PrePex/Surgery comparison study in Zimbabwe and a pilot implementation study in Mozambique. Methods: The studies calculated per male circumcision unit costs using a cost–analysis approach. Both direct costs (consumable and nonconsumable supplies, device, personnel, associated staff training) and selected indirect costs (capital and support personnel costs) were calculated. Results: The cost comparison in Zimbabwe showed a unit cost per VMMC of $45.50 for PrePex and $53.08 for surgery. The unit cost difference was based on higher personnel and consumable supplies costs for the surgical procedure, which used disposable instrument kits. In Mozambique, the costing analysis estimated a higher unit cost for PrePex circumcision ($40.66) than for surgery ($20.85) because of higher consumable costs, particularly the PrePex device and lower consumable supplies costs for the surgical procedure using reusable instruments. Supplies and direct staff costs contributed 87.2% for PrePex and 65.8% for surgical unit costs in Mozambique. Discussion: PrePex device male circumcision could potentially be cheaper than surgery in Zimbabwe, especially in settings that lack the infrastructure and personnel required for surgical VMMC, and this might result in programmatic cost savings. In Mozambique, the surgical procedure seems to be less costly compared with PrePex mainly because of higher consumable supplies costs. With reduced device unit costs, PrePex VMMC could become more cost-efficient and considered as complementary for Mozambique's VMMC scale-up program. PMID:27331599

AIM: To compare differences in the frequency of colorectal cancer at colonoscopy in Zimbabwe according to ethnicity. METHODS: All lower gastrointestinal endoscopic procedures performed between January 2006 and December 2011 at a gastroenterology clinic in Harare, Zimbabwe were reviewed. The demographic characteristics, clinical indications, differences in bowel preparation and the endoscopic and histological diagnoses were compared between different ethnic groups with emphasis on colorectal cancer. The clinical and demographic characteristics and the endoscopic findings were compared using the student t-test and the χ2 test, while the clinical indications associated with a diagnosis of colorectal cancer were determined by logistic regression. RESULTS: All colonoscopies and sigmoidoscopies performed in 1236 Caucasians, 460 black Africans and 109 Asians were analysed. Colorectal cancer was diagnosed more frequently in the black African patients compared to Caucasians or Asians (10% vs 3%, 10% vs 2%, P < 0.001). However, polyps were less common among black Africans (5%) compared to both Caucasians (8%) and Asians (9%) (P = 0.03). Among patients with colorectal cancer, black Africans tended to be younger than Caucasians, who were over-represented in the oldest age category; 32 % vs 2% were less than 50 years and 41% vs 78% were older than 60 years (P < 0.001). Anaemia and weight loss were associated with colorectal cancer in both black African [odds ratio (OR): 2.73 (95%CI: 1.33-5.61) and 3.09 (1.35-7.07)] and Caucasian patients [OR: 6.65 (95%CI: 2.93-15.09) and 3.47 (1.52-7.94)]. CONCLUSION: The likelihood of diagnosing colorectal cancer in patients referred for colonoscopy in Zimbabwe is at least as likely among black Africans as it is among Caucasians. PMID:25741144

Introduction Indoor residual spraying (IRS) and insecticide-treated nets (ITNs), two principal malaria control strategies, are similar in cost and efficacy. We aimed to describe recent policy development regarding their use in Mozambique, South Africa and Zimbabwe. Methods Using a qualitative case study methodology, we undertook semi-structured interviews of key informants from May 2004 to March 2005, carried out document reviews and developed timelines of key events. We used an analytical framework that distinguished three broad categories: interests, ideas and events. Results A disparate mix of interests and ideas slowed the uptake of ITNs in Mozambique and Zimbabwe and prevented uptake in South Africa. Most respondents strongly favoured one strategy over the other. In all three countries, national policy makers favoured IRS, and only in Mozambique did national researchers support ITNs. Outside interests in favour of IRS included manufacturers who supplied the insecticides and groups opposing environmental regulation. International research networks, multilateral organizations, bilateral donors and international NGOs supported ITNs. Research evidence, local conditions, logistic feasibility, past experience, reaction to outside ideas, community acceptability, the role of government and NGOs, and harm from insecticides used in spraying influenced the choice of strategy. The end of apartheid permitted a strongly pro-IRS South Africa to influence the region, and in Mozambique and Zimbabwe, floods provided conditions conducive to ITN distribution. Conclusions Both IRS and ITNs have a place in integrated malaria vector management, but pro-IRS interests and ideas slowed or prevented the uptake of ITNs. Policy makers needed more than evidence from trials to change from the time-honoured IRS strategy that they perceived was working. Those intending to promote new policies such as ITNs should examine the interests and ideas motivating key stakeholders and their own

A participatory epidemiological study was conducted to identify and prioritize constraints to livestock health and production on smallholder farms in Sanyati and Gokwe districts of Zimbabwe. Questionnaires were administered to 294 randomly selected livestock owners across the two districts. Livestock diseases (29% of the respondents), high cost of drugs (18.21%), weak veterinary extension (15.18%), inadequate grazing (13.60%), inadequate water (13.54%), and livestock thefts (10.44%) were the major livestock health and production constraints identified. The number of diseases reported varied (P<0.05) with livestock species and nature of causative agent. Out of the 36 diseases mentioned by farmers, 50%, 22.2%, 19.4%, 5.5% and 2.8% were diseases of cattle, sheep and goats, domestic chicken, donkeys, and guinea fowls, respectively. Seven (19.4%) of the 36 diseases including rabies and foot and mouth disease were those listed by the OIE. Thirty-four percent of the respondents rated bovine dermatophilosis as the most important livestock disease. Respondents rated, in descending order, other diseases including tick borne diseases (21%); a previously unreported disease, "Magwiriri" or "Ganda renzou" in vernacular (14%); mastitis (11%); parafilariosis (11%); and blackleg (9%). Cattle skin samples from "Magwiriri" cases had Besnoitia besnoiti parasites. Overall, this study revealed factors and diseases that limit livestock production in Zimbabwe and are of global concern; in addition, the study showed that the skin diseases, bovine dermatophilosis and besnoitiosis, have recently emerged and appear to be spreading, likely a consequence of ectoparasite control demise in smallholder farming areas of Zimbabwe over the last 15 years. PMID:23149306

The lithospheric mantle beneath the Kaapvaal-Zimbabwe craton of southern Africa shows variations in seismic P-wave velocity at depths within the diamond stability field that correlate with differences in the composition of diamonds and their syngenetic inclusions. Middle Archean mantle depletion events initiated craton keel formation and early harzburgitic diamond formation. Late Archean accretionary events involving an oceanic lithosphere component stabilized the craton and contributed a younger Archean generation of eclogitic diamonds. Subsequent Proterozoic tectonic and magmatic events altered the composition of the continental lithosphere and added new lherzolitic and eclogitic diamonds to the Archean diamond suite. PMID:12215642

A combination of factors are considered important in causing the failure and subsequent development of a flowslide of a gold mine waste dump (or tailings dam) at Arcturus, near Harare, Zimbabwe. These factors comprise poor basal drainage, steep perimeter walls, saturation of the walls and basal sediments through continued spigoting of slurry during a period of heavy rainfall, and the effect of this saturation on the tailings. Properties of the tailings, eyewitness accounts, documentary evidence, and site characteristics are discussed. The failure and subsequent development of a fatal 300-m flowslide are reconstructed in a five-phase developmental model. The general applicability of the results is discussed.

Policies and institutional frameworks associated with and / or impacting on agricultural water management (AWM) in smallholder farming systems in Zimbabwe were analyzed through literature reviews, feedback from stakeholder workshops, key informant interviews and evaluation of policy impacts on implemented case study projects/programmes. The study showed that Zimbabwe has gone a long way towards developing a water management policy addressing both equity and access, through the Water and ZINWA of 1998. However, lack of incentives for improving efficient management and utilization of water resources once water has reached the farm gate was apparent, apart from punitive economic instruments levied on usage of increased volumes of water. For example, the new water reforms of 1998 penalized water savers through loss of any unused water in their permits to other users. In addition, the ability of smallholder farmers to access water for irrigation or other purposes was influenced by macro and micro-economic policies such as Economic Structural and Adjustment Programme (ESAP), Zimbabwe Programme for Economic and Social Transformation (ZIMPREST), prevailing monetary and fiscal policies, as well as the Land and Agrarian Reform policies. For instance, the implementation of ESAP from 1991 to 95 resulted in a decline in government support to management of communal irrigation schemes, and as a result only gravity-fed schemes survived. Also AWM projects/programmes that were in progress were prematurely terminated. While considerable emphasis was placed on rehabilitation of irrigation infrastructure since the fast track land reform in 1998, the policies remained rather silent on strategies for water management in rainfed systems. The piecemeal nature and fragmentation of policies and institutional frameworks scattered across government ministries and sectors were complex and created difficulties for smallholder farmers to access water resources. Poor policy implementation

One hundred and forty-two social work students in Harare, Zimbabwe, were questioned concerning their sources and memory of information concerning the human immunodeficiency virus (HIV) and AIDS. Newspapers were cited most frequently as the major source of information. Family and friends were not reported to be major sources of information. An analysis of the kinds of items most frequently recalled showed that articles concerning personal portrayals were the most powerful vehicles for AIDS information. Metaphors and similes for AIDS produced by the students mirrored those commonly reported elsewhere. Jokes were studied as indicators of informal opinions, and these showed negative views of American involvement in AIDS issues. PMID:8217473

- The application of fallout radionuclides (FRNs) in soil erosion and redistribution studies has gained popularity since the late 1980s. In Zimbabwe, soil erosion research was mostly based on conventional methods which included the use of erosion plots for quantitative measurements and erosion models for predicting soil losses. Only limited investigation to explore the possibility of using Caesium-137 (Cs-137) has been reported in the early 1990s for undisturbed and cultivated lands in Zimbabwe. In this study, the Cs-137 technique was applied to assess the impact of soil conservation practices on soil losses and to develop strategies and support effective policies that help farmers in Zimbabwe for sustainable land management. The study was carried out at the Makoholi research station 30 km north of the Masvingo region which is located 260 km south of Harare. The area is semi-arid and the study site comprises coarse loamy sands, gleyic lixisols. The conservation agriculture (CA) practices used within the area since 1988 include (i) direct seeding (DS) with mulch, (ii) CA basins with mulch, and (iii) 18 years direct seeding, left fallow for seven years and turned into conventional tillage since 2012 (DS/F/C). The Cs-137 reference inventory was established at 214 ± 16 Bq/m2. The mean inventories for DS, CA basins and DS/F/C were 195, 190 and 214 Bq/m2 respectively. Using the conversion Mass Balance Model 2 on the Cs-137 data obtained along transects for each of the practices, gross erosion rates were found to be 7.5, 7.3 and 2.6 t/ha/yr for direct seeding, CA basins and the DS/F/C while the net erosion rates were found to be 3.8, 4.6 and 0 t/ha/yr respectively. Sediment delivery ratios were 50%, 63% and 2% in the respective order. These preliminary results showed the effectiveness of DS over CA basins in erosion control. The efficiency of fallowing in controlling excessive soil loss was significant in the plot that started as DS for 18 years but left fallow for 7

Educational achievement has important implications for the health and well-being of young women in sub-Saharan Africa. The authors assessed the effects of providing school support on educational outcomes of orphan girls in rural Zimbabwe. Data were from a randomized controlled trial offering the intervention group comprehensive schooling support and controls no treatment initially and then fees only. Results indicated comprehensive support reduced school dropout and absence but did not improve test scores. Providing support to orphan girls is promising for addressing World Health Organization Millennium Development Goals, but further research is needed about contextual factors affecting girls' school participation and learning. PMID:25692731

The document is the second volume of a final report for Phase II of a feasibility study conducted for the Regional Water Authority (RWA) of Zimbabwe. The report documents the second phase of a study to assess the feasibility of developing groundwater for irrigation of the Chisumbanje area. This phase of the study included installation of test boreholes in several locations. The volume encompasses the technical scope of work and addendum. The following subjects are discussed in the volume: geographic setting; concepts for successful location of groundwater; and technical approach to the project. A proposed scope of work, schedule and project liaison are presented.

Zimbabwe has widespread and widely disseminated epidemics of most major sexually transmitted infections (STI) including HIV. This epidemiological situation is examined from a broad historical perspective, exploring the interactions between the population incidence of STI and the social profile of the country. The results suggest opportunities for upstream prevention efforts. Examples of these include: integration of prevention with care and social support; increasing general communication and openness about sexuality; economic support initiatives including income generating and micro-credit programmes, offering living accommodations for families in cities, mines, and military camps; and programmes focusing on adolescents before they become sexually active. PMID:12083446

Zimbabwe has widespread and widely disseminated epidemics of most major sexually transmitted infections (STI) including HIV. This epidemiological situation is examined from a broad historical perspective, exploring the interactions between the population incidence of STI and the social profile of the country. The results suggest opportunities for upstream prevention efforts. Examples of these include: integration of prevention with care and social support; increasing general communication and openness about sexuality; economic support initiatives including income generating and micro-credit programmes, offering living accommodations for families in cities, mines, and military camps; and programmes focusing on adolescents before they become sexually active. PMID:12083446

Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

In Zimbabwe the need to incorporate indigenous knowledge in science education to reflect local cultural settings cannot be overemphasized. Current policies on science are situated in Western cultural definitions, thus marginalizing indigenous knowledge, which is misconceived as irrational and illogical. This study used qualitative research…

The study sought to establish and compare the views of rural and urban primary school pupils on homework in Zimbabwe, using six purposively sampled Masvingo rural and urban primary schools. The inquiry employed a qualitative methodology in which data were gathered through semi-structured personal interviews and document analysis. A sample of…

The purpose of this research was to make comparative study of the development and review process of the entrepreneurship curriculum at the University of Zimbabwe (UZ) Faculty of Commerce and Botho University, (BU) Faculty of Business and Accounting in Gaborone, Botswana. The study focused on the processes and influences of curriculum development…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide presents activities,…

An examination is an important component of any institution that educates people. It is a form of assessment used to measure the students' understanding of the concepts and principles they would have learnt. Zimbabwe Open University, an Open and Distance Learning institution has been setting its own examinations for the academic programmes…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and environmental laboratories. This ZIM-SCI study guide consists of…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide presents activities…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide is a three-part unit…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide presents activities…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the third year of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide is a five-part unit…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide is a three-part unit…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the third year of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be used in…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the third year of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide is a four-part unit…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide presents activities…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be used in…

Developments in vocational education and training (VET) in Tanzania and Zimbabwe since the 1980s were examined in the context of economic reform. Formal VET provision in each country's public and private sectors was reviewed, and case studies of one firm in each country's manufacturing and tourism industries were conducted. The research identified…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide presents activities…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

This publication forms the second volume of a report on a study of the school supervision system in four African countries. (The research is part of a larger series of studies sponsored by UNESCO and the International Institute for Educational Planning.) The countries studied were Botswana, Namibia, Tanzania, and Zimbabwe. The study examined the…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide contains instructional…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

This paper explores the construction of dominant models of gender among students in the Vocational-Technical. In the backdrop of dominant narratives that structure gender policies and practices in schooling in Zimbabwe, the paper elaborates upon how students' daily experiences in workrooms perpetuate the feminisation and masculinisation of fields…

Anthracnose occurs in most sorghum producing regions worldwide and the pathogen is highly variable; thus, additional sources of resistance are needed for sorghum improvement. To identify resistant sources, 41 sorghum accessions from the Matabeleland North Province of Zimbabwe were evaluated for fol...

SC Siesta soybean seeds were planted at Rattray Arnold Research Station in Enterprise Land near Harare, Zimbabwe on 10 Dec 2005 in four row plots, 20 ft. long, with 30 in row spacing and two rows of border. the experimental design was a randomized complete block design with four replications. Treat...

The study sought to explore the impact of the commitment and political will exhibited by the Government of Zimbabwe through the Presidential Scholarship Scheme in promoting regionalisation of higher education. The methodology employed document analysis, interviews and questionnaires to gather data from the stakeholders. The officials responsible…

This study examines the relationship between educators' locus of control and job stress using samples from the US and Zimbabwe. Multiple regression analyses are used to identify significant relationships in the US sample between teachers' external locus of control and the severity of the job stress that they experience, coupled with the perceived…

This paper reports on a study of the role of parent governors in five neighbouring rural primary schools in Zimbabwe. The study proposed that despite the presence of a legal decentralised school governance structure in which parents form the majority, they did not have the capacity to function effectively therein, and were still marginalised in…

This study sought to explore female lecturers' participation in civil engineering research and development activities at one polytechnic in Zimbabwe. Case study design was chosen for this study to make predictions, narration of events, comparisons and drawing of conclusions. The female lecturers were purposively sampled to participate in the…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide presents activities…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

The study sought to determine lecturers' and students' perceptions of factors contributing to students' failure to submit research projects on time in three departments of the Zimbabwe Open University. The study employed a descriptive survey design and was both quantitative and qualitative. The questionnaire used as a data-gathering instrument had…

In this study, we report results of a study examining the relationship between home environment factors and reading achievement in Zimbabwe. The study utilised data collected by the Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEQ). The data were submitted to linear regression analysis through structural equation…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This teaching guide, designed to be read in…

Compares Zimbabwe's rapidly expanding educational system to those of Kenya, Malawi, Tanzania, Zambia, Australia, Canada, New Zealand, United Kingdom, and United States with regard to enrollment rates, government expenditures, per pupil costs, student teacher ratios, teacher salaries, internal efficiency, and cost per graduate. Contains 16…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide presents activities…

This study assessed the policies, strategic plans and structures that have been put in place in Zimbabwe to address the HIV/AIDS epidemic in the education sector. It also examined the comprehensiveness of projects and programmes currently being implemented by the government in collaboration with partner organisations and NGOs. The findings show…

This paper briefly introduces Early Intervention (EI) issues in five countries including Zimbabwe, Poland, People's Republic of China (PRC), India, and the United States of America (USA). In the overview section the national background, including religious, socio-economic development, and political systems, its policies, laws and acts, are…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide presents activities…

In parts of the world, including many developing countries, climate variability impacts negatively on agricultural production and natural resource management. Workshops in applied climatology were held in Australia, India, Indonesia and Zimbabwe between 1999 and 2002 to provide farmers and agricultural and meteorological staff a better…

The Zimbabwe Secondary School Science Project (ZIM-SCI) developed student study guides, corresponding teaching guides, and science kits for a low-cost science course which could be taught during the first 2 years of secondary school without the aid of qualified teachers and conventional laboratories. This ZIM-SCI study guide introduces students to…

Environmental flow requirements for the Rusape River, a tributary of the Save River, in Zimbabwe, were estimated using a rapid results approach. Thirty years of hydrological data with daily time steps from gauging stations upstream and downstream of the Rusape Dam were analysed using DRIFT Software. The dam appeared to have caused an increase in intra-annual and inter-annual flood events downstream compared to upstream, including significant dry season releases, while inter-annual floods were larger. The water releases from the dam differ from the natural flow in both volume and frequency, especially in the dry season and may have had a negative impact on the local ecosystem and subsistence farmers. The building block method (BMM) was applied, using the hydrological analyses performed, in order to estimate environmental flow requirements, which are presented in mean monthly flows. The flow regime that is recommended for the Rusape River should reduce or reverse these impacts, whilst ensuring sufficient water resources are released for economic needs. The EFR proposed can be achieved within mean monthly flows observed. However, it should be stressed that the EFR proposed have been developed from a rapid method, and are only a first estimate of the EFR for the Rusape River. This study represents a step in developing a management plan for the Save Basin, shared between Zimbabwe and Mozambique.

In developing countries the cost of treating disease is much more than prevention and so there is now a lot of interest in understanding nutrition. In this pilot study we selected a cohort of pre-clinical students studying at the College of Health Sciences in the University of Zimbabwe. This study was carried to investigate the gender-based weekly consumption of different food categories amongst University of Zimbabwe students. Semi-structured questionnaires distributed to 100 undergraduate students (male= 47; female= 52). The proportion of male and female respondents, age and body weight did not differ significantly. Principal foods consumed by males included sadza and cerevita; naartjies, bananas and avocado pears; tomatoes, onions, covo and spinach; beef; and condensed milk and powdered milk occupied the larger proportions. Females frequently ate a lot of bread, cerevita, sadza and cereal; lemons and avocado pears; onions, tomatoes, rape and covo; beef and soya meat; creamer, powdered milk and milk. This study suggests that females consumed a greater variety of food, including the infrequent types by comparison with men. PMID:19445103

Sexual abuse during childhood is a public health and human rights concern throughout the world, including Sub-Saharan Africa. In 2011, Zimbabwe initiated national prevalence data collection on violence against children to inform government policy and programs. We interviewed 567 females and 589 males, aged 18-24 years following standardized and previously tested survey methods from the region. Of females 32.5%, and of males 8.9%, reported experiencing sexual violence before age 18. Most female (62.7%) and male (47.9%) victims of sexual violence experienced more than one incident of sexual violence prior to age 18 years. Three in four females (77.7%) and one in four males (26.7%) of those who experienced sexual violence reported that the first incident was perpetrated by a boyfriend or girlfriend. Few victims received professional help (2.7% of females and 2.4% of males who had reported experiencing sexual violence). Violence against girls is at epidemic levels in Zimbabwe. Most sexual violence against girls occurs within the context of peer relationships. Child victims who seek potentially life-saving support tend not to receive it. This study is evidence of a national public health and child rights emergency in the country and a case for increased, longer-term investment by the government and its development partners in policy reform for enhancing adolescent girls' empowerment and protection. PMID:25986577

A cross-sectional study was conducted in order to detect antibodies for Brucella canis (B. canis) in dogs from urban Harare and five selected rural communities in Zimbabwe. Sera from randomly selected dogs were tested for antibodies to B. canis using an enzyme-linked immunosorbent assay. Overall, 17.6% of sera samples tested (57/324, 95% CI: 13.5-21.7) were positive for B. canis antibodies. For rural dogs, seroprevalence varied from 11.7% - 37.9%. Rural dogs recorded a higher seroprevalence (20.7%, 95% CI: 15.0-26.4) compared with Harare urban dogs (12.7%, 95% CI: 6.9-18.5) but the difference was not significant (p = 0.07). Female dogs from both sectors had a higher seroprevalence compared with males, but the differences were not significant (p > 0.05). Five and two of the positive rural dogs had titres of 1:800 and 1:1600, respectively, whilst none of the positive urban dogs had a titre above 1:400. This study showed that brucellosis was present and could be considered a risk to dogs from the studied areas. Further studies are recommended in order to give insight into the epidemiology of brucellosis in dogs and its possible zoonotic consequences in Zimbabwe. Screening for other Brucella spp. (Brucella abortus, Brucella melitensis and Brucella suis) other than B. canis is also recommended. PMID:24830899

The Apostolic faith, a rapidly growing and increasingly influential force in Zimbabwe, has received attention in the literature due to its potential role in shaping its followers' attitudes and behaviours towards health. Existing literature, however, has only examined small cross-section samples from a few confined survey sites or has failed to adequately control for the many factors that may mediate the effects of religion. This paper examines the effects of the Apostolic faith on the usage of maternal health and child immunization services in Zimbabwe. It is based on a nationally representative sample from the 2009 Multi-Indicator Monitoring Survey and employs the established Andersen model on access to health services. Well controlled multivariate logit regression models derived from these data show that an affiliation with the Apostolic faith is a substantial and significant risk factor in reducing the utilization of both maternal and child health services. Moreover, even when the services were least costly and readily available and when gaps along other social and economic factors were limited, as in the case of Bacillus Calmette-Guérin vaccination and one visit to antenatal care, women and children from Apostolic faith families still fared significantly worse than others in accessing them. PMID:25108694

A total of 286 traditional healers, 85% of them registered with the Zimbabwe National Traditional Healers' Association (ZINATHA), in five administrative provinces of Zimbabwe, were interviewed to assess their knowledge about the signs and symptoms of urinary schistosomiasis. Information on the names of plants used to treat Schistosoma haematobium infections was solicited. Haematuria was mentioned by 99% of the traditional healers to be the most obvious sign of S. haematobium infection. General body weakness, increased urinary frequency and pain on micturition also were reported to be some of the signs of infection. Eight plant materials were identified as the most commonly used for the treatment of S. haematobium. The plants were identified and parts collected to investigate their antischistosomal properties. The plant materials were prepared according to the guidelines of the traditional healers and their efficacy determined by administering the crude extracts orally to hamsters infected with S. haematobium cercariae. The results obtained suggested that plant extracts from Abrus precatorius (Leguminosae), Pterocarpus angolensis (Leguminosae) and Ozoroa insignis (Anacardiaceae) were lethal to adult schistosomes. PMID:8072305

A cross-sectional study was conducted to detect the feline leukaemia virus (FeLV) p27 antigen and to determine risk factors and the haematological changes associated with infection in domestic cats in Zimbabwe. Sera were collected for detection of the p27 antigen, urea, creatinine, alanine aminotransferase and gamma-glutamyl transferase levels, whilst whole blood was collected for haematology. FeLV p27 antigen was detected using a rapid enzyme-linked immunosorbent assay (ELISA) test kit. Data on risk factors were analysed using a logistic regression model. Of the 100 cats tested, 41% (95% CI: 31.19% - 50.81%) (41/100) were positive for the FeLV p27 antigen. Sex and health status of cats were not significantly (p > 0.05) associated with infection. Intact cats (OR = 9.73), those living in multicat housing (OR = 5.23) and cats that had access to outdoor life (OR = 35.5) were found to have higher odds of infection compared with neutered cats, those living in single-cat housing, and without access to outdoor life, respectively. Biochemistry and haematology revealed no specific changes. The results showed that FeLV infection was high in sampled cats, providing evidence of active infection. Thus, it would be prudent to introduce specific control measures for FeLV infection in Zimbabwe. PMID:25686080

Introduction Cholera, an infectious diarrheal disease, has been shown to be associated with large scale hydroclimatic processes. The sudden and sporadic occurrence of epidemic cholera is linked with high mortality rates, in part, due to uncertainty in timing and location of outbreaks. Improved understanding of the relationship between pathogenic abundance and climatic processes allows prediction of disease outbreak to be an achievable goal. In this study, we show association of large scale hydroclimatic processes with the cholera epidemic in Zimbabwe reported to have begun in Chitungwiza, a city in Mashonaland East province, in August, 2008. Principal Findings Climatic factors in the region were found to be associated with triggering cholera outbreak and are shown to be related to anomalies of temperature and precipitation, validating the hypothesis that poor conditions of sanitation, coupled with elevated temperatures, and followed by heavy rainfall can initiate outbreaks of cholera. Spatial estimation by satellite of precipitation and global gridded air temperature captured sensitivities in hydroclimatic conditions that permitted identification of the location in the region where the disease outbreak began. Discussion Satellite derived hydroclimatic processes can be used to capture environmental conditions related to epidemic cholera, as occurred in Zimbabwe, thereby providing an early warning system. Since cholera cannot be eradicated because the causative agent, Vibrio cholerae, is autochthonous to the aquatic environment, prediction of conditions favorable for its growth and estimation of risks of triggering the disease in a given population can be used to alert responders, potentially decreasing infection and saving lives. PMID:26417994

This paper examines the relationship between bridewealth, socio-demographics, and sexual and reproductive practices among a group of women in Harare, Zimbabwe. The study sample was recruited as part of a six-month safety trial of the diaphragm and a microbicide, between August 2004 and April 2005 in Harare, Zimbabwe. Women underwent two screening visits: first, women completed a demographic and behavioral interviewer-administered questionnaire which included questions on bridewealth; at the second visit, women were offered HIV testing and counseling. Our results included: 417 women were married (currently or in the past) and almost half had had bridewealth negotiated as part of the marriage process. In multivariate analyses, women who were married with bridewealth had more years of education (OR 1.17, 95%CI 1.03-1.32), a higher age of coital debut (OR 1.37, 95%CI 1.09-1.71), and increased likelihood of having ever used male condoms (OR 1.54, 95%CI 1.01-2.37) compared with women who had been married without bridewealth. Bridewealth may be a relevant area of traditional culture to further examine in relation to HIV risk, for its potential association with co-factors that can reduce risk of HIV infection among women in Southern Africa. PMID:20467936

This paper examines the relationship between bridewealth, socio-demographics, and sexual and reproductive practices among a group of women in Harare, Zimbabwe. The study sample was recruited as part of a six-month safety trial of the diaphragm and a microbicide, between August 2004 and April 2005 in Harare, Zimbabwe. Women underwent two screening visits: first, women completed a demographic and behavioral interviewer-administered questionnaire which included questions on bridewealth; at the second visit, women were offered HIV testing and counseling. Our results included: 417 women were married (currently or in the past) and almost half had had bridewealth negotiated as part of the marriage process. In multivariate analyses, women who were married with bridewealth had more years of education (OR 1.17, 95%CI 1.03–1.32), a higher age of coital debut (OR 1.37, 95%CI 1.09–1.71), and increased likelihood of having ever used male condoms (OR 1.54, 95%CI 1.01–2.37) compared with women who had been married without bridewealth. Bridewealth may be a relevant area of traditional culture to further examine in relation to HIV risk, for its potential association with co-factors that can reduce risk of HIV infection among women in Southern Africa. PMID:20467936

Distal symmetrical poly-neuropathy (DSP) is a neurological complication associated with HIV/AIDS and stavudine (d4T) containing antiretroviral therapy. People with DSP experience pain, numbness and muscle weakness, which affect their quality of life (QOL). The purpose of this study was to establish the effect of a progressive-resisted exercise (PRE) intervention on health-related quality of life (HR-QOL) in people living with HIV/AIDS-related DSP. An assessor-blinded randomised controlled trial was conducted, with participants sourced from 10 clinics with HIV services, the family care clinic at Wilkins Hospital and 2 large hospitals in Harare, Zimbabwe. A 12-week PRE intervention was conducted twice weekly for 80 participants, while the control group with 80 participants continued with usual daily activities. The main outcome variable was HR-QOL for which we controlled for demographic and clinical measures in generalised estimating equation population-averaged models. Data were summarised and analysed using an intention to treat analysis approach using the Stata v10 program. Mean age of participants was 42.2 years (SD = 8.5). While d4T was used by 59% (n = 94), an equal proportion of the participants also had moderate to severe neuropathy. PRE was found to significantly improve HR-QOL in the intervention group based on the mean difference between the intervention group mean change and the mean change in the control group (F ratio 4.24; p = .04). This study established that PREs have positive effects on HR-QOL for people living with HIV/AIDS-related DSP. PMID:26729347

Background There is little evidence to date of the potential impact of vegetable gardens on people living with HIV (PLHIV), who often suffer from social and economic losses due to the disease. From 2008 through 2011, Action Contre la Faim France (ACF) implemented a project in Chipinge District, eastern Zimbabwe, providing low-input vegetable gardens (LIGs) to households of PLHIV. Program partners included Médecins du Monde, which provided medical support, and Zimbabwe's Agricultural Extension Service, which supported vegetable cultivation. A survey conducted at the end of the program found LIG participants to have higher Food Consumption Scores (FCS) and Household Dietary Diversity Scores (HDDS) relative to comparator households of PLHIV receiving other support programs. This study assessed the incremental cost-effectiveness of LIGs to improve FCS and HDDS of PLHIV compared to other support programs. Methods This analysis used an activity-based cost model, and combined ACF accounting data with estimates of partner and beneficiary costs derived using an ingredients approach to build an estimate of total program resource use. A societal perspective was adopted to encompass costs to beneficiary households, including their opportunity costs and an estimate of their income earned from vegetable sales. Qualitative methods were used to assess program benefits to beneficiary households. Effectiveness data was taken from a previously-conducted survey. Results Providing LIGs to PLHIV cost an additional 8,299 EUR per household with adequate FCS and 12,456 EUR per household with HDDS in the upper tertile, relative to comparator households of PLHIV receiving other support programs. Beneficiaries cited multiple tangible and intangible benefits from LIGs, and over 80% of gardens observed were still functioning more than one year after the program had finished. Conclusions Cost outcomes were 20–30 times Zimbabwe's per capita GDP, and unlikely to be affordable within government

A world-wide revolution in thinking about public sector management has occurred in recent years, termed the 'new public management'. It aims to improve the efficiency of service provision primarily through the introduction of market mechanisms into the public sector. The earliest form of marketization in developed countries has tended to be the introduction of competitive tendering and contracts for the provision of public services. In less wealthy countries, the language of contracting is heard with increasing frequency in discussions of health sector reform despite the lack of evidence of the virtues (or vices) of contracting in specific country settings. This paper examines the economic arguments for contracting district hospital care in two rather different settings in Southern Africa: in South Africa using private-for-profit providers, and in Zimbabwe using NGO (mission) providers. The South African study compared the performance of three 'contractor' hospitals with three government-run hospitals, analysing data on costs and quality. There were no significant differences in quality between the two sets of hospitals, but contractor hospitals provided care at significantly lower unit costs. However, the cost to the government of contracting was close to that of direct provision, indicating that the efficiency gains were captured almost entirely by the contractor. A crucial lesson from the study is the importance of developing government capacity to design and negotiate contracts that ensure the government is able to derive significant efficiency gains from contractual arrangements. In other parts of Africa, contracts for hospital care are more likely to be agreed with not-for-profit providers. The Zimbabwean study compared the performance of two government district hospitals with two district 'designated' mission hospitals. It found that the two mission hospitals delivered similar services to those of the two government hospitals but at substantially lower unit

Manpower projections for oral health are generally held to be more accurate than those for other health sectors since the diseases involved and their treatment times can be predicted more precisely. Nevertheless most oral health manpower projections are either overestimates or are not in line with the resources of individual countries, especially in developing countries. Zimbabwe was taken as the study case, and oral health manpower projections were made using two of the most commonly employed methods and one new approach. The projections obtained using the three methods were all different, and even the lowest projection is beyond the resources of the country. It is recommended that in making oral health manpower projections, the facilities available to accommodate these personnel should also be taken into account. PMID:1893510

Objectives: Exclusive breast feeding (EBF) uptake in Zimbabwe is very low. Given that EBF is a physiological process which transpires in a specific socio-economic milieu, this study investigates the socio-economic factors militating against its uptake. Methods: The study used a mixed research methodology. The concurrent nested model of mixed methods was utilized using one data collection phase, during which both quantitative and qualitative data were collected simultaneously. Results: The research noted that factors such as low education, low income, gender inequalities, social influence, and traditional practices were hindering the uptake of exclusive breast feeding. Conclusions and Global Health Implications: The study envisages that it is pertinent for infant feeding programs to address socio-economic barriers to EBF in order to influence a positive uptake. The potential interventions include increasing men’s involvement, raising awareness on EBF, and strengthening the Village Health Worker Program.

Cell-culture-derived clones of eight Toxoplasma gondii isolates from Zimbabwe were characterised in IFAT with a panel of five monoclonal antibodies (mAb). Each clone had been established from a single murine brain cyst. The antibodies were bradyzoite-specific (4.3), tachyzoite-specific (4.25, 5.1 and anti-P(30)), or tachyzoite- and bradyzoite-specific (5.15). Their strong reactivity with the bradyzoite-specific mAb 4.3 and their weaker reactivity with the tachyzoite-specific 4.25, 5.1 and anti-P(30) indicated that all the isolates are probably of genetic type II. Each of the isolates reacted in the IFAT in a similar way to the Danish reference strain of T. gondii, SSI-119. PMID:15949185

In July-August 1992, a directory was made of research projects on socio-behavioural aspects of HIV infection and AIDS in Zimbabwe. A total of 92 research projects were identified, most of which were already completed. Whilst there was a wide variety of topics, populations and geographical areas covered, there was a strong bias towards AIDS awareness and knowledge, attitudes and practices (KAP) studies. Many of these were not linked with any specific AIDS prevention programme or with policy making. Suggestions are given to make better use of existing scientific information. A call is made upon researchers to conduct action-oriented studies and to consult HIV/AIDS programme implementers when specifying 'researchable' problems, so as to increase the likelihood that the study results will indeed have an impact on policy making and programme implementation. PMID:8261502

The possible impact of climate change on maize (Zea mays L.) production in Zimbabwe was evaluated simulating crop production under climate scenarios generated by global climate models (GCMs). The baseline climate data for each site also was modified by increasing daily air temperatures by 2 and 4 C for a sensitivity analysis. Temperature increases of 2 and 4 C, reduced maize yields at all sites. Maize yields also decreased under the GCM climate change scenarios, even when the direct beneficial effects of CO{sub 2} are included in the simulation. Major changes in the farming system can compensate for some of the yield decreases under climate change, but the additional fertilizer, seed supplies, and irrigation required could be costly. The semi-extensive farming zone seems to be particularly sensitive to the changes in climate simulated. Farmers in this zone would be further marginalized if the risk of low maize yields increases as projected by the results of this study.

Infestations of adults and nymphs of Amblyomma hebraeum were counted on Brahman (Br), Brahman x Simmental (BS), Sanga (Sa) and Hereford (He) steers exposed to infested pastures at Mbizi in southern Zimbabwe in 1986-1987. Herefords were always the most heavily infested, while the Sanga tended to carry the fewest ticks with the Brahman and Brahman x Simmental groups being in between. The ratios of the engorged females on the four breeds were 2.3:1.4:1.4:1.0 for He:Br:BS:Sa. The ratios of the standard nymphs were 2.2:1.4:1.7:1.0 for He:Br:BS:Sa. The results confirm earlier observations in Africa and support the view that there are genetic differences between breeds in the expression of resistance to this tick species. PMID:8952073

In 1992-3 and 1995-6, Zimbabwe used a Child Supplementary Feeding Programme (CSFP) to combat child malnutrition during drought-induced emergencies. Previous evaluations of the CSFP relied on routine administrative data and key informant interviews and made only cursory use of available household survey data. These evaluations concluded that the CSFP was effective in preventing an increase in malnutrition among children under five, especially in 1992-3. The more-detailed analysis of household surveys provided in this article suggests that CSFP coverage was generally patchy and disappointingly low, especially in 1995-6. There is little evidence that children from poor or nutritionally vulnerable households got preferential access to supplementary feeding. The CSFP failed to feed many malnourished and nutritionally vulnerable children even in areas where the programme was operating. Household survey evidence suggests that the CSFP's impact on nutritional status was likely marginal, especially in 1995-6. PMID:12227592

In this study we tested whether cotton fields contribute more than cereal fields to African elephant (Loxodonta africana) habitat loss through its effects on woodland fragmentation in the Mid-Zambezi Valley, Zimbabwe. In order to test this hypothesis, we first mapped cotton and cereal fields using MODIS remotely sensed data. Secondly, we analysed the effect of the area of cotton and cereal fields on woodland fragmentation using regression analysis. We then related the fragmentation indices, particularly edge density with elephant distribution data to test whether elephant distribution was significantly related with woodland fragmentation resulting from cotton fields. Our results showed that cotton fields contributed more to woodland fragmentation than cereal fields. In addition, results showed that the frequency of the African elephant increased where cotton fields were many and small relative to cereal fields. We concluded that cotton fields are the main driver of woodland fragmentation and therefore elephant habitat in the Mid-Zambezi Valley compared with cereal fields.

Zimbabwe's homogeneous precipitation regions are investigated by means of principal component analysis (PCA) with regard to the underlying processes related to ENSO and/or Indian Ocean Dipole zonal mode (IODZM). Station standardized precipitation index rather than direct rainfall values represent the data matrix used in the PCA. The results indicate that the country's rainfall is highly homogeneous and is dominantly described by the first principal mode (PC1). This leading PC can be used to represent the major rainfall patterns affecting the country, both spatially and temporarily. The current practice of subdividing the country into the two seasonal rainfall forecast zones becomes irrelevant. Partial correlation analysis shows that PC1 is linked more to the IODZM than to the traditional ENSO which predominantly demonstrates insignificant association with PC1. The pure IODZM composite is linked to the most intense rainfall suppression mechanisms, while the pure El Niño composite is linked to rainfall enhancing mechanisms. PMID:22645470

Male impotence and infertility are health and social problems that have resulted in significant suffering to men the world over. From an African perspective, and in Zimbabwe in particular, the taboo nature of male impotence and infertility carries a lot of mystique. Based on evidence from focus-group discussions, in-depth and key-informant interviews, this study reveals rural Shona people to have indigenous knowledge systems that trigger the investigation of signs of impotence (perceived as associated with male infertility) at infancy, puberty and after marriage. Male infertility carries overtones of failure, frustration, pain, social ostracism, stigma, marital instability, discomfiture and suicide. Intervention strategies to remedy perceived problems were exclusively sociocultural, involving the administration of traditional herbs and traditional healers' divination. Given the existence of indigenous knowledge systems for the investigation and mediation of male impotence and infertility, it is worth incorporating traditional healers in future strategies targeting these emasculating conditions. PMID:23550631

This study aimed at examining the epidemiological features of rabies in humans in Zimbabwe. The data were taken from internal reports of the department of veterinary technical services at Harare covering the period 1st January 1992-31st December 2003 inclusive. Positive cases were examined in relation to age and sex of the victim, animal vector involved, season, and land-use categories. The majority of the confirmed positive human cases (85.7%) were recorded in communal areas. The 5-19 year age group and males constituted a highly vulnerable group. Over 90% of the cases were due to dog bites with jackals (Canis adustus and C. mesomelas), and honey badgers (Mellivora capensis) also contributing to the positive cases. Rabid cats and rabid wild animals had a high relative risk (RR) of biting humans. Animal-to-human transmission was highest during the dry months of July to November. PMID:17543871

This article identifies the important issues addressed by programs and projects that are aimed at promoting women's equality through entrepreneurship and suggests several actions for future focus of gender programs and training. Culture was seen as a barrier to the self-confident and autonomous economic activities of women in Zimbabwe. Likewise, structural barriers such as lack of marketable skills, time and ability to travel, land and assets, education, and position as primary family providers all compounded to the problem of entrepreneurship among women. Establishment of policy approaches for women like vocational skills training augmented by training in business skills and marketing, however, are insufficient since it failed to discuss and transfer behavioral skills necessary to make one an entrepreneur. To conclude, programs must be designed to empower personal skills and self-awareness, as well as address the constraints to entrepreneurship, and macroeconomic policy change. PMID:12349641

No prevalence data on pneumonoconiosis among Zimbabwe's 30,000 miners have been available. Passage of a 1984 law requiring examination of all miners has provided a data base to assess this, but the records had not been previously evaluated or stored in a manner to facilitate this. In 1988 we developed a strategy to utilize the existing records to estimate cross-sectional rates rapidly. In this report, we describe the approach and demonstrate high rates of simple pneumonoconiosis among long-term workers in the coal, nickel, copper, and gold mines. These data, though limited, provide a rationale for more detailed investigations in these workforces and an impetus to establish an ongoing surveillance plan for the nation's miners.

Introduction Voluntary Medical Male Circumcision (VMMC) is the surgical removal of the foreskin by a trained health worker. VMMC was introduced in Zimbabwe in 2009. It is of concern that the programme performance has been below expectations nationally and in Mazowe district. Zimbabwe is unlikely to meet its 2015 target of circumcising 1 200 000 men aged between 15 and 29 years and unlikely to enjoy maximum benefits of VMMC which include prevention of HIV, sexually transmitted infections and cervical cancer. We therefore broadly aimed at identifying factors influencing the level of VMMC uptake in Mazowe district. Methods An analytic cross-sectional study was carried out in Mazowe district. A multi-stage probability sampling strategy was used to select 300 men aged between 18 and 49 years. Pretested interviewer administered questionnaires, key informant interviews and focus group discussions were used to collect data. Quantitative data was analysed using Epi info where odds ratios and p-values were calculated. Qualitative data was analysed thematically. Results Being of Shona origin (AOR= 7.69 (95%CI 1.78-33.20)), fear of pain (AOR= 7.09 (95%CI 2.58-19.47)) and fear of poor wound healing (AOR= 2.68 (95%CI 1.01-7.08)) were independently associated with being uncircumcised while having a circumcised friend and encouragement by a friend or relative were independently associated with being circumcised. Conclusion Fear of pain, fear of poor wound healing and encouragement by a friend or relative were associated with circumcision status. Widening use of surgical devices and third part referrals may assist in scaling up the programme. PMID:25918577

Young women who sell sex (YWSS) in Southern Africa are highly vulnerable to HIV, as the risks of being young and female in a high prevalence setting coalesce with those of commercial sex. YWSS are less able to negotiate safe sex, more likely to have higher risk partners, and less likely to use available health services compared to older sex workers. In Zimbabwe's national HIV programme for sex workers, fewer than 1% of clients were 15-29. We developed monthly interactive workshops for YWSS based on an Activity Pack consisting of 21 sessions organised into six modules. The aim was to encourage YWSS' interaction with each other, build their trust, confidence and skills, and encourage uptake of clinical services. We conducted a process evaluation to assess programme strengths, identify challenges, and recommend changes. This paper presents findings synthesising programme records with qualitative data and discusses feasibility, acceptability, and outputs during the pilot phase. In total, 143 YWSS attended meetings and most were from the target 15-19-year-old age group. Participants enjoyed the sessions and reported improved cooperation, willingness to negotiate with clients, and self-reflection about their futures. Staff found facilitating sessions easy and activities clear and appropriate. Challenges included identifying appropriate referrals, initial recruitment of women in some sites, and managing participants' requests for financial compensation. The number of clients aged 15-19 increased at sex worker clinics in all sites. This programme is the first to target YWSS in Zimbabwe to address their disproportionately low service use. It proved feasible to staff and acceptable to participants over a one-year period. Given enhanced vulnerability of YWSS, this programme provides one workable model for reaching this underserved group. PMID:27391994

This cost-effectiveness study analyzes the cost per quality-adjusted life year (QALY) gained in a randomized controlled trial that tested school support as a structural intervention to prevent HIV risk factors among Zimbabwe orphan girl adolescents. The intervention significantly reduced early marriage, increased years of schooling completed, and increased health-related quality of life. By reducing early marriage, the literature suggests the intervention reduced HIV infection. The intervention yielded an estimated US$1, 472 in societal benefits and an estimated gain of 0.36 QALYs per orphan supported. It cost an estimated US$6/QALY gained, about 1% of annual per capita income in Zimbabwe. That is well below the maximum price that the World Health Organization (WHO) Commission on Macroeconomics and Health recommends paying for health gains in low and middle income countries. About half the girls in the intervention condition were boarded when they reached high school. For non-boarders, the intervention’s financial benefits exceeded its costs, yielding an estimated net cost savings of $502 per pupil. Without boarding, the intervention would yield net savings even if it were 34% less effective in replication. Boarding was not cost-effective. It cost an additional $1,234 per girl boarded (over the three years of the study, discounted to present value at a 3% discount rate) but had no effect on any of the outcome measures relative to girls in the treatment group who did not board. For girls who did not board, the average cost of approximately three years of school support was US$973. PMID:23334923

Information on the spatial distribution of aquatic weeds is required for understanding the evolution of weed invasion and propagation rates. Such information is also vital for identifying affected areas and relating weed abundance to probable changes in environmental conditions and human actions including management practices within the lake and its catchment. Information on aquatic weed distribution also assists in evaluating the effectiveness of control measures and management actions. In Zimbabwe, Lake Chivero has been characterised by aquatic weed proliferation since the 1970s. Field surveys done between December 2005 and March 2006 showed concentrations of 1.2 mg/l and 0.3 mg/l up from 0.3 mg/l and 0.03 mg/l in 2001 for phosphates and nitrates respectively. Proliferation of aquatic weeds will continue unless nutrient loadings to this lake are reduced. The aim of this paper was to assess the feasibility of mapping the spatial extent and abundance of aquatic weeds in Lake Chivero, Zimbabwe using Landsat images. Landsat images of 1976, 1989 and 2000 were used to calculate the normalised difference vegetation index (NDVI) which was used for estimating the spatial extent of aquatic weeds and weed biomass. Field data and actual biomass measurements were obtained between December 2005 and March 2006 by harvesting weeds from the lake. This was subsequently related to NDVI and used to estimate the abundance of the different weed species. The results indicate that the weed coverage in Lake Chivero declined from 42% in 1976, 36% in 1989 to 22% in 2000. The research also demonstrated that Typha capensis has more biomass, 11.1kg per square metre, than any other weed type and hence higher abundance in all the years. It was concluded that remote sensing is an invaluable asset for detection of invasions, assessment of infestation levels, monitoring rate of spread, and determining the efficacy of weed mitigation measures.

Background Medical male circumcision (MMC) has become a significant dimension of HIV prevention interventions, after the results of three randomised controlled trials in Uganda, South Africa and Kenya demonstrated that circumcision has a protective effect against contracting HIV of up to 60%. Following recommendations by the World Health Organization, Zimbabwe in 2009 adopted voluntary MMC as an additional HIV prevention strategy to the existing ABC behaviour change model. Purpose The purpose of this study is thus to investigate the factors contributing to the low uptake of MMC. Methods The study was a quantitative cross-sectional survey conducted in Mutare rural district, Zimbabwe. Questionnaires with open- and closed-ended questions were administered to the eligible respondents. The target population were male participants aged 15–29 who met the inclusion criteria. The households were systematically selected with a sample size of 234. Statistical Package for the Social Sciences was used to analyse the data. Results Socioculturally, circumcised men are viewed as worthless (37%), shameful (30%) and are tainted as promiscuous (20%), psychological factors reported were infection and delayed healing (39%), being ashamed and dehumanised (58%), stigmatised and discriminated (40.2%) and fear of having an erection during treatment period (89.7%) whilst socio-economic factors were not having time, as it will take their time from work (58%) and complications may arise leading to spending money on treatment (84%). Conclusion Knowledge deficits regarding male medical circumcision lead to low uptake, education on male medical circumcision and its benefits. Comprehensive sexual health education should target men and dispel negative attitudes related to the use of health services. PMID:27380850

A five-year (1994-1999) back trajectory climatology has been established for Rukomechi Research Station/Zimbabwe (Zambezi Valley, 16^o 09' S, 29^o 26'E). Mixed layer air trajectories passing over Rukomechi are described in terms of directions of origin, wind speed, and inter- and intra annual periods of predominant flow. Trajectories show four possible source regions of air mass transport to Rukomechi: (1) northern Madagascar and Mozambique (with high winds during October/ November and low winds during December/January), (2) the Indian ocean south of Madagascar (with high and low winds during March and August/September, respectively), (3) the southern Atlantic and the tip of South Africa regions (with high winds during the middle of austral winter (June/July)), and (4) Zambia and Angola (bringing in mid-wet season air masses, which might carry the influence of the ITCZ). We also observed recirculating air masses which seem not to portray any season characteristics and which change year-by-year. The slow component of corridor (2) shows prevailing tendency, it is the main contributor of airflow to Rukomechi and it is dominant in the dry period (October to December). The year-to-year temporal variations show that 1997 was an abnormal year for the airflow over the research site. This has to be studied together with the variation in the meteorological parameters like rainfall during this period to find the influence of northern Zimbabwe air masses flows on the regional weather patterns. The importance of the presented classification is to narrow potential source regions of trace constituents and their most likely times of influence at Rukomechi througout the year on a monthly basis.

Background Haemovigilance hinges on a systematically structured reporting system, which unfortunately does not always exist in resource-limited settings. We determined the incidence and pattern of transfusion-related adverse events reported to the National Blood Service Zimbabwe. Materials and methods A retrospective review of the transfusion-event records of the National Blood Service Zimbabwe was conducted covering the period from 1 January 1999 to 31 December 2011. All transfusion-related event reports received during the period were analysed. Results A total of 308 transfusion adverse events (0.046%) were reported for 670,625 blood components distributed. The majority (61.6%) of the patients who experienced an adverse event were female. The median age was 36 years (range, 1–89 years). The majority (68.8%) of the adverse events were acute transfusion reactions consisting of febrile non-haemolytic transfusion reactions (58.5%), minor allergies (31.6%), haemolytic reactions (5.2%), severe allergic reactions (2.4%), anaphylaxis (1.4%) and hypotension (0.9%). Two-thirds (66.6%) of the adverse events occurred following administration of whole blood, although only 10.6% of the blood was distributed as whole blood. Packed cells, which accounted for 75% of blood components distributed, were associated with 20.1% of the events. Discussion The incidence of suspected transfusion adverse events was generally lower than the incidences reported globally in countries with well-established haemovigilance systems. The administration of whole blood was disproportionately associated with transfusion adverse events. The pattern of the transfusion adverse events reported here highlights the probable differences in practice between different settings. Under-reporting of transfusion events is rife in passive reporting systems. PMID:24887217

This cost-effectiveness study analyzes the cost per quality-adjusted life year (QALY) gained in a randomized controlled trial that tested school support as a structural intervention to prevent HIV risk factors among Zimbabwe orphan girl adolescents. The intervention significantly reduced early marriage, increased years of schooling completed, and increased health-related quality of life. By reducing early marriage, the literature suggests the intervention reduced HIV infection. The intervention yielded an estimated US$1,472 in societal benefits and an estimated gain of 0.36 QALYs per orphan supported. It cost an estimated US$6/QALY gained, about 1 % of annual per capita income in Zimbabwe. That is well below the maximum price that the World Health Organization (WHO) Commission on Macroeconomics and Health recommends paying for health gains in low and middle income countries. About half the girls in the intervention condition were boarded when they reached high school. For non-boarders, the intervention's financial benefits exceeded its costs, yielding an estimated net cost savings of $502 per pupil. Without boarding, the intervention would yield net savings even if it were 34 % less effective in replication. Boarding was not cost-effective. It cost an additional $1,234 per girl boarded (over the 3 years of the study, discounted to present value at a 3 % discount rate) but had no effect on any of the outcome measures relative to girls in the treatment group who did not board. For girls who did not board, the average cost of approximately 3 years of school support was US$973. PMID:23334923

Incidence rates of different cancers have been calculated for the black population of Harare, Zimbabwe for a 20-year period (1991-2010) coinciding with continuing social and lifestyle changes, and the peak, and subsequent wane, of the HIV-AIDS epidemic. The overall risk of cancer increased during the period in both sexes, with rates of cervix and prostate cancers showing particularly dramatic increases (3.3% and 6.4% annually, respectively). By 2004, prostate cancer had become the most common cancer of men. The incidence of cancer of the esophagus, formerly the most common cancer of men, has remained relatively constant, whereas rates of breast and cervix cancers, the most common malignancies of women, have shown significant increases (4.9% and 3.3% annually, respectively). The incidence of Kaposi sarcoma increased to a maximum around 1998-2000 and then declined in all age groups, and in both sexes The incidence of squamous cell cancers of the conjunctiva is relatively high, with temporal trends similar to those of Kaposi sarcoma. Non-Hodgkin lymphoma, the fifth most common cancer of men and fourth of women, showed a steady increase in incidence throughout the period (6.7-6.9% annually), although rates in young adults (15-39) have decreased since 2001. Cancer control in Zimbabwe, as elsewhere in sub-Saharan Africa, involves meeting the challenge of emerging cancers associated with westernization of lifestyles (large bowel, breast and prostate), while the incidence of cancers associated with poverty and infection (liver, cervix and esophagus) shows little decline, and the residual burden of the AIDS-associated cancers remains significant. PMID:23364833

Planting basins and ripper tillage practices are major components of the recently introduced conservation agriculture package that is being extensively promoted for smallholder farming in Zimbabwe. Besides preparing land for crop planting, these two technologies also help in collecting and using rainwater more efficiently in semi-arid areas. The basin tillage is being targeted for households with limited or no access to draught animals while ripping is meant for smallholder farmers with some draught animal power. Trials were established at four farms in Gwanda and Insiza in southern Zimbabwe to determine soil water contributions and runoff water losses from plots under four different tillage treatments. The tillage treatments were hand-dug planting basins, ripping, conventional spring and double ploughing using animal-drawn implements. The initial intention was to measure soil water changes and runoff losses from cropped plots under the four tillage practices. However, due to total crop failure, only soil water and runoff were measured from bare plots between December 2006 and April 2007. Runoff losses were highest under conventional ploughing. Planting basins retained most of the rainwater that fell during each rainfall event. The amount of rainfall received at each farm significantly influenced the volume of runoff water measured. Runoff water volume increased with increase in the amount of rainfall received at each farm. Soil water content was consistently higher under basin tillage than the other three tillage treatments. Significant differences in soil water content were observed across the farms according to soil types from sand to loamy sand. The basin tillage method gives a better control of water losses from the farmers’ fields. The planting basin tillage method has a greater potential for providing soil water to crops than ripper, double and single conventional ploughing practices.

The pace of hospital merger and acquisition activity reflects the economic theory of supply and demand: Publicly traded hospital companies, private equity funds, and large nonprofit hospital systems are investing capital to purchase and operate freestanding community hospitals at a time when many of those hospitals find themselves short of capital reserves and certain forms of management expertise. But the sale of those community hospitals also raises questions about the impact of absentee ownership on the communities which those hospitals serve. PMID:21864058

This study examines the relationship between educators' locus of control and job stress using samples from the US and Zimbabwe. Multiple regression analyses are used to identify significant relationships in the US sample between teachers' external locus of control and the severity of the job stress that they experience, coupled with the perceived degree of organisational support received. However, this relationship between the locus of control and stress indices could not be identified for the Zimbabwean sample. Significant differences between the two samples were noted in terms of educators' perceptions of the frequency of poor organisational support, with the Zimbabwean teachers reporting greater dissatisfaction. To explain these differences, a qualitative approach was utilised to illuminate the contextual stressors that educators face in Zimbabwe. The implications for teacher preparation measures are discussed.

Background Scaling up voluntary medical male circumcision (VMMC) to 80% of men aged 15–49 within five years could avert 3.4 million new HIV infections in Eastern and Southern Africa by 2025. Since 2009, Tanzania and Zimbabwe have rapidly expanded VMMC services through different delivery (fixed, outreach or mobile) and intensity (routine services, campaign) models. This review describes the modality and intensity of VMMC services and its influence on the number and age of clients. Methods and Findings Program reviews were conducted using data from implementing partners in Tanzania (MCHIP) and Zimbabwe (PSI). Key informant interviews (N = 13 Tanzania; N = 8 Zimbabwe) were conducted; transcripts were analyzed using Nvivo. Routine VMMC service data for May 2009–December 2012 were analyzed and presented in frequency tables. A descriptive analysis and association was performed using the z-ratio for the significance of the difference. Key informants in both Tanzania and Zimbabwe believe VMMC scale-up can be achieved by using a mix of service delivery modality and intensity approaches. In Tanzania, the majority of clients served during campaigns (59%) were aged 10–14 years while the majority during routine service delivery (64%) were above 15 (p<0.0001). In Zimbabwe, significantly more VMMCs were done during campaigns (64%) than during routine service delivery (36%) (p<0.00001); the difference in the age of clients accessing services in campaign versus non-campaign settings was significant for age groups 10–24 (p<0.05), but not for older groups. Conclusions In Tanzania and Zimbabwe, service delivery modalities and intensities affect client profiles in conjunction with other contextual factors such as implementing campaigns during school holidays in Zimbabwe and cultural preference for circumcision at a young age in Tanzania. Formative research needs to be an integral part of VMMC programs to guide the design of service delivery modalities in the face of, or

Under the new Water Act [Government of Zimbabwe, 1998. Water Act, Chapter 20:24, No. 31/98. Government Printers, Harare] of Zimbabwe which abolished the priority date system for the allocation of surface water in a catchment, it is widely believed that the alternative will be the proportional water allocation system. The proportional water allocation system has been practiced by groups of water users in a number of sub-catchments in Zimbabwe including Mupfuri, Mazowe and Odzi River systems, mainly in the form of dam syndicates (groups of users jointly owning a dam) and irrigation companies (groups of irrigators sharing one source of water). This paper presents the practical experiences with, and lessons that can be learnt from proportional water allocation in the Odzani River Irrigation Company (ORIC) on the Odzi River system in Manicaland in Zimbabwe. ORIC was formed under the provisions of the old Water Act after the construction of the canal, and currently has 50 irrigating members. They are engaged in a variety of agricultural enterprises that include crop production, horticulture and dairying. All members have sub-permits (sub-rights) that enable them to draw water, but the company has a single permit to abstract water from the Odzi River into their supply canal. Farmers’ perception and understanding of proportional water allocation varied but generally defined it as getting a certain percentage of water depending on the amount available in the canal and one’s water permit. One of the major sources of problems in ORIC is inequitable access to water arising from water poaching. Overall, ORIC farmers felt that for proportional water allocation to work properly, the services of a fulltime water bailiff are required, farmers must have their own storage facilities, water should be metered, members should participate fully in decision making, politics should be kept to a minimum and conflicts must be resolved internally.

Zimbabwe, like most of Sub-Saharan Africa, has been hard-hit by HIV/ AIDS. National estimates reported by the Ministry of Health and Child Welfare put the prevalence rates of HIV in the age group between 15 and 49 at 15.3% (World Health Organization [WHO], UNICEF, & UNAIDS, 2008). This is one of the highest HIV/AIDS prevalence rates in the world…

Malaria constitutes a major public health problem in Zimbabwe, particularly in the north and east bordering Zambia and Mozambique. In Manicaland Province in eastern Zimbabwe, malaria transmission is seasonal and unstable. Over the past decade, Manicaland Province has reported increased malaria transmission due to limited funding, drug resistance and insecticide resistance. The aim of this study was to identify risk factors at the individual and household levels to better understand the epidemiology of malaria and guide malaria control strategies in eastern Zimbabwe. Between October 2012 and September 2014, individual demographic data and household characteristics were collected from cross-sectional surveys of 1,116 individuals residing in 316 households in Mutasa District, one of the worst affected districts. Factors associated with malaria, measured by rapid diagnostic test (RDT), were identified through multilevel logistic regression models. A total of 74 participants were RDT positive. Sleeping under a bed net had a protective effect against malaria despite pyrethroid resistance in the mosquito vector. Multivariate analysis showed that malaria risk was higher among individuals younger than 25 years, residing in households located at a lower household density and in closer proximity to the Mozambique border. The risk factors identified need to be considered in targeting malaria control interventions to reduce host-vector interactions. PMID:27114289

In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples. PMID:25711185

... tends to be more serious than other lung infections because: People in the hospital are often very sick and cannot fight off ... prevent pneumonia. Most hospitals have programs to prevent hospital-acquired infections.

Moderate Resolution Imaging Spectroradiometer (MODIS) data forms the basis for numerous land use and land cover (LULC) mapping and analysis frameworks at regional scale. Compared to other satellite sensors, the spatial, temporal and spectral specifications of MODIS are considered as highly suitable for LULC classifications which support many different aspects of social, environmental and developmental research. The LULC mapping of this study was carried out in the context of the development of an evaluation approach for Zimbabwe's land reform program. Within the discourse about the success of this program, a lack of spatially explicit methods to produce objective data, such as on the extent of agricultural area, is apparent. We therefore assessed the suitability of moderate spatial and high temporal resolution imagery and phenological parameters to retrieve regional figures about the extent of cropland area in former freehold tenure in a series of 13 years from 2001-2013. Time-series data was processed with TIMESAT and was stratified according to agro-ecological potential zoning of Zimbabwe. Random Forest (RF) classifications were used to produce annual binary crop/non crop maps which were evaluated with high spatial resolution data from other satellite sensors. We assessed the cropland products in former freehold tenure in terms of classification accuracy, inter-annual comparability and heterogeneity. Although general LULC patterns were depicted in classification results and an overall accuracy of over 80% was achieved, user accuracies for rainfed agriculture were limited to below 65%. We conclude that phenological analysis has to be treated with caution when rainfed agriculture and grassland in semi-humid tropical regions have to be separated based on MODIS spectral data and phenological parameters. Because classification results significantly underestimate redistributed commercial farmland in Zimbabwe, we argue that the method cannot be used to produce spatial

This paper presents practical experiences into the pattern of domestic water use, benefits and the gender realities. The study was undertaken in two districts of Zimbabwe, Mt Darwin and Bikita covering a total of 16 villages. The study aimed to assess the patterns of domestic water use, benefits derived from its use among the gender groups. Methodology for participatory assessment (MPA) was used for data collection and was done in a participatory manner. Traditionally most people in Zimbabwe are subsistence farmers who rely on rain fed agriculture. Where primary water sources are available such as shallow wells, family wells, deep wells and boreholes households use the water for household water and sanitation, irrigate small family gardens as well as their livestock. The survey established that women and men usually rank uses of water differently. In the two districts it was evident that women are playing more roles in water use and it is apparent that women are most often the users, managers and guardians of household water and hygiene. Women also demonstrated their involvement in commercial use of water, using water for livestock watering (20%) as well as brick moulding (21%). These involvement in commercial use were influenced by survival economics as well as the excess and reliability of the supply. The different roles and incentives in water use of women and men was demonstrated in how they ranked the benefits of water and sanitation. Men ranked clean drinking water among others as a top priority while women ranked improved health and hygiene and reduced distance as top priority. Overall the benefits highlighted by the communities and especially women were meeting the practical needs such as better access to water and reducing their work load. The assessment demonstrated the active role of women in water sources management highlighting quality, reliability and restrictions to their use. Though the communities gave the impression that decision making in the

Heartwater, caused by the rickettsial organism Cowdria ruminantium, is a serious constraint to livestock development in much of sub-Saharan Africa. Traditionally, the disease has been controlled by the use of chemical acaricides to control the vector tick. The University of Florida/USAID-supported heartwater research project (based in Zimbabwe) is developing a new inactivated vaccine to control the disease. In order that the vaccine is used effectively, the project has been studying the epidemiology of the disease in different livestock production systems of Zimbabwe, and evaluating the economic impact of the disease and of its future control using a vaccine such as the one under development. Initially, field studies were conducted to characterise the communal and commercial livestock-productions systems at risk from heartwater and to understand the epidemiology of the disease. The data from these studies were then applied to an infection-dynamics model of heartwater, which was used to provide estimates of disease incidence and impact under various scenarios over a period of 10 yr. Two principal outputs of the epidemiological model (cumulative annual heartwater incidence and infection-fatality proportion) were key inputs into an economics model. The estimated total annual national losses amount to Z$ 61.3 million (US$ 5.6 million) in discounted value terms over 10 yr. Annual economic losses per animal in the commercial production system (Z$ 56 discounted values) are 25 times greater than the losses in the communal system (Z$ 2.2). The greatest component of economic loss is acaricide cost (76%), followed by milk loss (18%) and treatment cost (5%). Losses in outputs other than milk (beef, traction and manure) appear to be minimal. A new vaccine has the promise of a benefit: cost ratio of about 2.4:1 in the communal and 7.6:1 in the commercial system. A control strategy based on a new vaccine would yield additional non-financial benefits to farmers and the government

Background Zimbabwe has been severely affected by the HIV/AIDS and tuberculosis epidemics, with an estimated 80% of tuberculosis patients being HIV infected. We set out to use annual population-mortality records from the cities of Harare and Bulawayo to describe trends and possible causes of mortality from 1979 to 2008. The specific objectives were to document overall, sex and age-specific mortality, proportion of deaths attributed to AIDS and tuberculosis, and changes in death rates since the start of antiretroviral therapy in 2004. Methods This retrospective descriptive study used existing mortality records of the Health Services departments in Harare and Bulawayo. Data points included: estimated yearly total population; groupings by sex and age; deaths (total and by sex and age groups for each year of the study period); and most frequently reported causes of death (for age groups <15 years, 15-44 years and ≥45 years). Data on deaths were aggregated by year, and crude, sex- and age-specific death rates were calculated per 1000 population. Tuberculosis and HIV-related disease-specific death rates and proportion of deaths attributed to these conditions were computed. Results In both cities, crude death rates were lowest in the late 1980s, increased three- to five-fold by the early 2000s, and began a slow and, in the case of Bulawayo, intermittent decline from 2004. Sex-specific death rates followed a similar trend, being higher in males than in females. The death rates in the age groups <5 years, 15-44 years and ≥45 years showed significant increases, with a gradual levelling off and decline from 2002 onwards; death rates in those aged 5-14 years were relatively unaffected. Tuberculosis and HIV caused 70% of deaths in the age group of 15-44 years from the early 1990s. Conclusions This study used routinely collected population-mortality data that are rare in resource-limited settings, and it described, for the first time in Zimbabwe, the effects of the HIV

Membership of indigenous local community groups was protective against HIV for women, but not for men, in eastern Zimbabwe during the period of greatest risk reduction (1999-2004). We use four rounds of data from a population cohort to investigate: (1) the effects of membership of multiple community groups during this period; (2) the effects of group membership in the following five years; and (3) the effects of characteristics of groups hypothesised to determine their effect on HIV risk. HIV incidence from 1998 to 2003 was 1.18% (95% CI: 0.78-1.79%), 0.48% (0.20-1.16%) and 1.13% (0.57-2.27%), in women participating in one, two and three or more community groups at baseline versus 2.19% (1.75-2.75%) in other women. In 2003-2005, 36.5% (versus 43% in 1998-2000) of women were members of community groups, 50% and 56% of which discussed HIV prevention and met with other groups, respectively; the corresponding figures for men were 24% (versus 28% in 1998-2000), 51% and 58%. From 2003 to 2008, prior membership of community groups was no longer protective against HIV for women (1.13% versus 1.29%, aIRR = 1.25; p = 0.23). However, membership of groups that provided social spaces for dialogue about HIV prevention (0.62% versus 1.01%, aIRR = 0.54; p = 0.28) and groups that interacted with other groups (0.65% versus 1.01%, aIRR = 0.51; p = 0.19) showed non-significant protective effects. For women, membership of a group with external sponsorship showed a non-significant increase in HIV risk compared to membership of unsponsored groups (adjusted odds ratio = 1.63, p = 0.48). Between 2003 and 2008, membership of community groups showed a non-significant tendency towards higher HIV risk for men (1.47% versus 0.94%, p = 0.23). Community responses contributed to HIV decline in eastern Zimbabwe. Sensitive engagement and support for local groups (including non-AIDS groups) to encourage dialogue on positive local responses to HIV and to challenge harmful social norms and incorrect

Regional aeromagnetic data from the south-central Zimbabwe Craton have been digitally processed and enhanced for geological and structural mapping and tectonic interpretation integrated with gravity data, to constrain previous interpretations based on tentative geologic maps and provide new information to link these structural features to known tectonic events. The derived maps show excellent correlation between magnetic anomalies and the known geology, and extend lithological and structural mapping to the shallow/near subsurface. In particular, they reveal the presence of discrete crustal domains and several previously unrecognised dykes, faults, and ultramafic intrusions, as well as extensions to others. Five regional structural directions (ENE, NNE, NNW, NW, and WNW) are identified and associated with trends of geological units and cross-cutting structures. The magnetic lineament patterns cut across the >2.7 Ga greenstone belts, which are shown by gravity data to be restricted to the uppermost 10 km of the crust. Therefore, the greenstone belts were an integral part of the lithosphere before much of the upper crustal (brittle) deformation occurred. Significantly, the observed magnetic trends have representatives craton-wide, implying that our interpretation and inferences can be applied to the rest of the craton with confidence. Geological-tectonic correlation suggests that the interpreted regional trends are mainly 2.5 Ga (Great Dyke age) and younger, and relate to tectonic events including the reactivation of the Limpopo Belt at 2.0 Ga and the major regional igneous/dyking events at 1.8-2.0 Ga (Mashonaland), 1.1 Ga (Umkondo), and 180 Ma (Karoo). Thus, their origin is here inferred to be inter- and intra-cratonic collisions and block movements involving the Zimbabwe and Kaapvaal Cratons and the Limpopo Belt, and later lithospheric heating and extension associated with the break-up of Gondwana. The movements produced structures, or reactivated older fractures

The AIDS advice of Ajonye Fermina Acuba, a trainer with the Federation of Uganda Employers (FUE), is provided in a serious of questions and answers. Other workplace experiences in Zimbabwe and India are reported. Questions were asked about the nature of the AIDS program in Uganda, the secrets of the program's success, the experiences of educators, and progress since 1988. FUE is nationally active with 150 member companies and 900 volunteer employees trained for peer education. Success was tied to proper selection of trainers, who were picked by union representatives and department heads. Training was over 3 days. 75% are men, but training is conducted for men and women together. success is attributed to the type of training and followup. Common problems overcome during training concern talking about changing sexual behavior. Employees initially believe educational efforts are only to promote condoms, but when risk reduction through any method is emphasized, the barriers are removed. Educators talk repeatedly with interested persons. Trainers requested better training to handle "first aid" situations before referral. Managers need specialized training programs. In Zimbabwe, commercial farm owners are engaging in AIDS educational activities through the Commercial Farmers' Union. 4500 farm owners and managers are represented. The program has operated since 1986 by providing volunteer coordinators from branch associations to initiate discussion with village leaders and later the community. AIDS committees are set up at the village level. Education focused on the fatal nature of the disease and lack of cure, the relationship with sexually transmitted diseases (STDS) which transmission can be prevented with condoms, the danger to women of sterility from STDs, and the price of not preventing through education is having to care for relatives' children. Stigma has been thus reduced. In India, the AIDS Research Foundation of India (AFRI), which is financed by local companies

Our study was designed to identify the relationships between climate parameters, such as precipitation, and δ18O values of tree ring α-cellulose extracted from exactly dated tree rings of Pterocarpus angolensis trees growing in the arid to semiarid Mzola region of western Zimbabwe. This species is known to be sensitive to variation in rainfall. In this region, the wet season occurs during the austral summer from mid November to early April followed by a dry winter season from around June through October. Overall, the total annual rainfall exhibits a high degree of spatial and temporal variation with a mean of less than 600 mm per year. We applied the Modified Brendel technique to isolate α-cellulose from raw wood samples extracted from two P. angolensis trees and measured the δ18O values using continuous flow isotope ratio mass spectrometry. We developed a 30-year (1955-1984) δ18O chronology and correlated it with tree-ring width, meteoric water δ18O values, monthly and seasonal precipitation totals, and mean monthly temperature. The δ18O values of meteoric water for this region were obtained from the Global Network of Isotopes in Precipitation (GNIP) and correlated with the δ18O values of tree ring α-cellulose. We identified a positive correlation (p=.03) between the δ18O in tree ring α-cellulose and the δ18O values of meteoric water. The δ18O values are significantly negatively correlated (p=0.01) with precipitation during November through February. This trend is consistent with depleted δ18O values measured in summer precipitation during periods of high rainfall, most likely the result of the isotopic amount effect reported in tropical regions. We also investigated the possibility of an isotopic temperature effect for δ18O in rainfall, which also may be reflected in the δ18O values in tree ring α-cellulose. The strongest correlations with temperature (positive values) were found in the previous December, June and July, with p-values ranging from

In southern Africa, gross disparities in access to water are symptomatic of the overall uneven pattern of development. Despite post-independence egalitarian rhetoric, in countries such as Zambia and Zimbabwe inappropriate models (piped house connections in the urban areas, high technology irrigation schemes in the agricultural sector), combined with weak macro-economies and poorly formulated sectoral policies have actually exacerbated the disparities. Zero or very low tariffs have played a major role in this. Although justified as being consistent with water’s special status, inadequate tariffs in fact serve to undermine any programme of making water accessible to all. This has led to a narrowing of development options, resulting in exclusivist rather than inclusivist development, and stagnation rather than dynamism. A major part of the explanation for perpetuation of such unsatisfactory outcomes is the existence of political interest groups who benefit from the status quo. The first case study in the paper involves urban water consumers in Zambia, where those with piped water connections seek to continue the culture of low tariffs which is by now deeply embedded. The result is that the water supply authorities (in this case the newly formed, but still politically constrained ‘commercialised utilities’) are unable even to maintain adequate supplies to the piped customers, let alone extend service to the peri-urban dwellers, 56% of whom do not have access to safe water. The paper outlines some modest, workable principles to achieve universal, affordable access to water in the urban areas, albeit through a mix of service delivery mechanisms. In a second case study of rural productive water in Zimbabwe, the reasons for only 2% of the rural subsistence farming households being involved in formal small-scale irrigation schemes 20 years after independence are explored. Again, a major part of the explanation lies in government pursuing a water delivery model which

Although heat treatment of human milk is an official infant-feeding recommendation for human immunodeficiency virus (HIV)-positive mothers in Zimbabwe, its implementation has not been adequately addressed, because knowledge about the safety of this method is rudimentary and its acceptability is poorly understood. To address this knowledge gap, the authors conducted focus group discussions among mothers, grandmothers, midwives, and husbands in various regions of Zimbabwe. Although the practice of heat treating expressed human milk was initially met with skepticism because of potential obstacles, including time constraints and social and cultural stigma, a pattern of opinion reversal emerged in all groups. By the end of each discussion, participants believed that, given its affordability and its potential to protect infants from HIV infection, heat-treated human milk may be a feasible infant-feeding option for HIV-positive mothers in Zimbabwe. These findings merit further investigation so that appropriate behavioral strategies can be designed. PMID:16467287

The objectives of a hospital are to improve patient care, while the objectives of a hospital library are to improve services to the staff which will support their efforts. This handbook dealing with hospital administration is designed to aid the librarian in either implementing a hospital library, or improving services in an existing medical…

Increased interest in the measurement of hospital quality has been stimulated by accrediting bodies, purchaser coalitions, government agencies, and other entities. This paper examines quality measurement for hospitals in rural settings. We seek to identify rural hospital quality measures that reflect quality in all hospitals and that are sensitive…

With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature. PMID:10283019

For the ca. 2.7 Ga (Neoarchean) clastic rocks in the Belingwe greenstone belt (Manjeri Formation), U-Pb age of detrital zircon grains were analyzed by Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS). The Manjeri Formation, composed of sandstone, quartzite, and limestone with stromatolites, was deposited in a shallow marine setting along the ancient passive continental margin of the Zimbabwe craton. Nearly 100 detrital zircon grains, for each from two sandstone samples in central Zimbabwe, were separated for U-Pb dating. Age spectra of detrital zircon grains of two analyzed sandstones of the Manjeri Formation show more or less the same multiple age clusters: i.e., ca. 2.9 Ga, ca. 3.15 Ga, ca. 3.3 Ga, and ca. 3.5 Ga. These age spectra reflect nature of the provenance of proto-Zimbabwe, which was considerably different from that of the modern Zimbabwe craton. The age clusters of ca. 2.9 Ga, ca. 3.3 Ga, and ca. 3.5 Ga are correlated with those of extant basement rocks of the present Zimbabwe craton, whereas the ca. 3.15 Ga cluster has no corresponding unit within the craton, except for detrital zircons from the 2.65 Ga Shamvaian Group in a neighboring area of the Zimbabwe craton. The extremely old (3.85 Ga; Eoarchean) detrital zircon grains, previously reported from the ca. 2.9 Ga and ca. 3.4 Ga sandstones elsewhere in the craton, were not detected at all in the present two analyzed samples. As no Eoarchean (>3.8 Ga) basement rocks remain in the Zimbabwe craton at present either, the present study confirmed that the Eoarchean crustal rocks once occurred in the proto-Zimbabwe craton but they had been removed secondarily from the provenance of Neoarchean and younger basins prior to 2.7 Ga. Possible geologic processes for such disappearance of older crusts may include the physiological separation by continental rifting, subduction erosion, and/or other crustal recycling processes.

Water quality is an urgent problem in the Lake Chivero catchment, Zimbabwe, whilst water scarcity will be a problem soon. This study focused on assessing the potential impacts of the application of cleaner production principles in urban water supply and sanitation in the context of sustainable management of water resources. The cleaner production principles are explained together with how they can be applied to urban water management. Data from City of Harare and previous studies were collected and analysed. The study focused mainly on water, nitrogen and phosphorus. About 304,000 m 3/d of wastewater, containing 30,000 kg/d TN and 3600 kg/d TP are currently produced and treated at five sewage treatment works in Harare. Water conservation, treatment and reuse strategies were developed for different land uses starting from water-saving devices, regulation, leak detection and repair, to wastewater treatment and reuse. This study showed that the application of the cleaner production principles would reduce total wastewater production from 487,000 m 3/d to 379,000 m 3/d (a 27% reduction) based on year 2015 projections. A very large investment in treatment infrastructure can be postponed for about 10 years. In terms of amounts treated and discharged at central level this translates to reductions of 47% on flows, 34% on TN, and 44% on TP. River discharges can be eliminated. It was concluded that a cleaner production approach could substantially reduce current water pollution and long-term scarcity problems in Harare.

This study examines whether children in rural Zimbabwe have differing representations of their HIV/AIDS-affected peers based on the gender of those peers. A group of 128 children (58 boys, 70 girls) aged 10-14 participated in a draw-and-write exercise, in which they were asked to tell the story of either an HIV/AIDS-affected girl child, or an HIV/AIDS-affected boy child. Stories were inductively thematically coded, and then a post hoc statistical analysis was conducted to see if there were differences in the themes that emerged in stories about girls versus stories about boys. The results showed that boys were more often depicted as materially deprived, without adult and teacher support, and heavily burdened with household duties. Further research is needed to determine whether the perceptions of the children in this study point to a series of overlooked challenges facing HIV/AIDS-affected boys, or to a culture of gender inequality facing HIV/AIDS-affected girls - which pays more attention to male suffering than to female suffering. PMID:26615976

As part of the effort to establish industrial practice and public policy regarding asbestos in Zimbabwe, we have conducted a cross-sectional study of the chrysotile mines and mills. A stratified random sample of workers with greater than 10 years of exposure has been evaluated by spirometry, chest radiographs, and employment history. The latter was converted to quantitative estimates of exposure dose, using a matrix based on measured and reconstructed fiber levels for each job and facility during the years of work. Based on these data, a clear dose-response between asbestos exposure and functional loss has been demonstrated, with mean losses from predicted of about 400-600 cc in vital capacity in the 10% of the population with heaviest exposures. Low-grade parenchymal radiographic abnormalities (ILO grade greater than or equal to 1/0) were evident in 8.7% of the total study group and were almost 10 times more common in those with more than 100 fibers/cc.years cumulative exposure than in those with 16 fibers/cc.years or less. Pleural disease was relatively rare, occurring in just under 10% of the study group, and was unrelated to exposure dose. Overall, these findings are compatible with results of similar studies in Quebec and Swaziland and suggest that similar control strategies are probably indicated.

The aim of this study was to formulate an integrated wastewater management model for Harare, Zimbabwe, based on current thinking. This implies that wastewater is treated/disposed of as close to the source of generation as possible. Resource recovery and reuse in a local thriving urban agriculture are integrated into this model. Intervention strategies were considered for controlling water, nitrogen and phosphorus flows to the lake. In the formulation of strategies, Harare was divided into five major operational areas of high-, medium-, and low-density residential areas, and also commercial and industrial areas. Specific options were then considered to suit landuse, development constraints and socio-economic status for each area, within the overall criteria of limiting nutrient inflows into the downstream Lake Chivero. Flexible and differential solutions were developed in relation to built environment, population density, composition of users, ownership, future environmental demands, and technical, environmental, hygienic, social and organisational factors. Options considered include source control by the users (residents, industries, etc.), using various strategies like implementation of toilets with source separation, and natural methods of wastewater treatment. Other possible strategies are invoking better behaviour through fees and information, incentives for cleaner production, and user responsibility through education, legislative changes and stricter controls over industry. PMID:12793656

There is limited capacity in terms of knowledge and experience on how to calculate the environmental water requirements (EWR) in Zimbabwe. In this paper the EWR were assessed using the desktop model developed by [A Desktop Model used to provide an initial estimate of the ecological instream flow requirements of rivers in South Africa. Institute for Water Research, Rhodes University, Grahamstown, 2001] and a spreadsheet model (Waflex) was developed to incorporate a component of EWR in reservoir simulation. The paper assesses whether EWR as established by Hughes method can be incorporated into a reservoir simulation and water allocation model, and if it is possible to derive EWR directly from naturalised flow series. The paper further considers the possibility of using the concept of capacity sharing for allocating water rights to the environment. The results show that at present use levels the EWR in the Odzi river can easily be met. However when in future water abstractions will increase, the effective water releases for the environmental will increase significantly. Also a very simple method is proposed to establish a first approximation of EWR. The paper shows that the capacity sharing model concept is a transparent institutional arrangement, which can be used to allocate water rights to the environment. It can be concluded that the Waflex model can provide practical guidelines to catchment managers and dam operators to implement EWR.

Background Patients at elevated risk of drug-resistant tuberculosis are prioritized for testing with Xpert MTB/RIF® (“Xpert”), though clinical utility in this population is understudied. Design From November 2011 to June 2014, consecutive outpatients with history of prior tuberculosis in high-density suburbs of Harare, Zimbabwe were tested with Xpert, solid and liquid culture, and the microscopically-observed drug susceptibility assay. Diagnostic accuracy for rifampin-resistance and time to second-line regimens were ascertained. The rpoB gene was sequenced in cases of culture-confirmed rifampin resistance and genotypic sensitivity. Results Among 352 retreatment patients, 71 (20%) had rifampin-resistant, 98 (28%) rifampin-susceptible, 64 (18%) culture-negative/Xpert-positive, and 119 (34%) culture-negative/Xpert-negative TB. Xpert was 86% (95% CI 75-93%) sensitive and 98% (95% CI 92-100%) specific for rifampin-resistant TB. The positive predictive value of Xpert-determined rifampin resistance for MDR-TB was 82% (95% CI 70-91%). Fifty-nine of 71 (83%) participants initiated SLDs, with a median time to regimen initiation of 18 days (IQR, 10-44 days). Conclusion The diagnostic accuracy of Xpert for rifampin-resistance is high, though predictive value for MDR-TB is lower than anticipated. Xpert allows for faster SLD initiation under programmatic conditions, relative to culture-based drug susceptibility testing. PMID:27287639

Pregnancy offers an opportunity for midwives to recognise and respond to women experiencing intimate partner violence (IPV). However, most antenatal care interventions have been conducted in private specialist services in high-income countries and do not address the structural and cultural realities of developing country settings. We report on an exploratory qualitative study conducted in antenatal public health facilities in Harare, Zimbabwe, involving six in-depth interviews with midwives and seven FGDs with 64 pregnant and postpartum women. Recorded interviews were transcribed verbatim and analysed using thematic content analysis. We found that identifying and responding to IPV in antenatal care is hampered by inadequate human, financial and infrastructural resources as well as poor support of gender-based violence training for midwives. Midwives had divergent views of their role, with some perceiving IPV as a non-clinical, social and domestic problem that does not require their attention, while others who had been sensitised to the problem felt that it could easily overwhelm them. A comprehensive response to IPV by midwives would be difficult to achieve in this setting but sensitised midwives could respond to cues to violence and ultimately assist abused women in culturally sensitive and appropriate ways. PMID:23343085

Social capital - especially through its ‘network’ dimension (high levels of participation in local community groups) - is thought to be an important determinant of health in many contexts. We investigate its effect on HIV prevention, using prospective data from a general population cohort in eastern Zimbabwe spanning a period of extensive behaviour change (1998-2003). Almost half of the initially uninfected women interviewed were members of at least one community group. In an ecological analysis of 88 communities, those with higher levels of community group participation had lower incidence of new HIV infections and more had adopted safer behaviours, although these effects were largely accounted for by differences in socio-demographic composition. Individual women in community groups had lower HIV incidence and more extensive behaviour change, even after controlling for confounding factors. Community group membership was not associated with lower HIV incidence in men, possibly reflecting a propensity amongst men to participate in groups that allow them to develop and demonstrate their masculine identities – often at the expense of their health. Support for women’s community groups could be an effective HIV prevention strategy in countries with large-scale HIV epidemics. PMID:22066129

Data from 20 years of cancer registration in Harare (Zimbabwe) are used to investigate the risk of cancer in the white population of the city (of European origin), relative to that in blacks (of African origin). In the absence of information on the respective populations-at-risk, we calculated odds of each major cancer among all cancers, and took the odds ratios of whites to blacks. Some major differences reflect obvious phenotypic differences (the very high incidence of skin cancer-melanoma and nonmelanoma--in the white population), whereas others (high rates of liver cancer, Kaposi sarcoma and conjunctival cancers in blacks) are the result of differences in exposure to infectious agents. Of particular interest are cancers related to lifestyle factors, and how the differences in risk are changing over time, as a result of evolving lifestyles. Thus, the high risk of cancers of the esophagus and cervix uteri in blacks (relative to whites) and colorectal cancers in whites show little change over time. Conversely, the odds of breast cancer, on average four times higher in whites than blacks, has shown a significant decrease in the differential over time. Cancer of the prostate, with the odds initially (1991-1997) 15% higher in whites had become 33% higher in blacks by 2004-2010. PMID:26437451

Given the wide range of oxygen isotopic composition of emerald from all over the world ( δ18O between +6.2 and +24.7‰), the δ18O V-SMOW values of emeralds from the Sandawana mines in Zimbabwe ( δ18O‰=+6.6 to +8.0), are relatively constant, among the lowest ever measured. These consistently low values can be explained by host-rock buffering in a very narrow emerald-bearing reaction zone between ultrabasic greenstones (metamorphosed komatiites) and albitised pegmatites. δ18O values of Sandawana emeralds overlap those of emeralds from Brazil, Austria, Australia and Madagascar, a fact indicating that, in these cases, oxygen isotope composition alone is not sufficient to determine the geographic origin of commercially available emeralds. However, stones with overlapping δ18O values may eventually be identified using a combination of physical properties, inclusion characteristics and chemical composition. To cite this article: J.C. Zwaan et al., C. R. Geoscience 336 (2004).

ABSTRACT This study examines whether children in rural Zimbabwe have differing representations of their HIV/AIDS-affected peers based on the gender of those peers. A group of 128 children (58 boys, 70 girls) aged 10–14 participated in a draw-and-write exercise, in which they were asked to tell the story of either an HIV/AIDS-affected girl child, or an HIV/AIDS-affected boy child. Stories were inductively thematically coded, and then a post hoc statistical analysis was conducted to see if there were differences in the themes that emerged in stories about girls versus stories about boys. The results showed that boys were more often depicted as materially deprived, without adult and teacher support, and heavily burdened with household duties. Further research is needed to determine whether the perceptions of the children in this study point to a series of overlooked challenges facing HIV/AIDS-affected boys, or to a culture of gender inequality facing HIV/AIDS-affected girls – which pays more attention to male suffering than to female suffering. PMID:26615976

{open_quotes}Rootfuel,{close_quotes} made by drying the fast-growing starchy-cellulosic taproots of certain members of the family Cucurbitaceae, has been under investigation by us since 1985. Rootfuel can be quickly dried to a much lower level of moisture content than seasoned wood, and also unlike wood, it contains a very small amount of lignin. If it is dry and burned with good draft, it can be burned more slowly than wood with very little smoke production. We studied rootfuel made from Cucurbita foetidissima roots in dry, deforested and well-populated rural lands of Mexico, Brazil, Zimbabwe and India under sponsorship of the Biomass Users Network, with funding from the Rockefeller Foundation. Our purpose was to evaluate rootfuel as a replacement for wood, dung and crop residues to improve indoor air quality for health reasons, and to take pressure off of the remaining trees. Acceptability has been uniformly high. Small test plots have been planted, and new rootfuel species have been identified and tested.

This article examines the interplay of changes in urban environments, economic reforms and women's strategies in sustaining family livelihood through a case study based on the survey of off-plot urban cultivators in Harare, Zimbabwe. It also exemplifies the nature of gender-based conflicts arising from varying perceptions of the uses of open urban spaces. This article is organized into four sections. The first section briefly discusses some contemporary issues regarding urban agriculture in eastern and southern Africa. Specifically, it examines the role of women and the conflicts that arise over the use of urban spaces for agricultural activities from the perspective of women's struggle and strategies for sustaining family livelihood. The second section gives some background to urban agriculture in Harare, emphasizing the contribution of urban agriculture to women's strategies for maintaining household food and cash income security as a response to economic reforms and how this comes into conflict with Harare City Council's view. The third and fourth section discusses the results of the survey of urban agriculturists, illuminating how female participation in the activity has distinctive motivations and contributions to the household and the urban economy. Finally, the conclusion outlines the challenges to city planning in a tropical country faced with demand for agricultural use within the urban environment. PMID:12322325

Zimbabwe’s poor are predominantly located in the semi-arid regions and rely on rainfed agriculture for their subsistence. Decline in productivity, scarcity of arable land, irrigation expansion limitations, erratic rainfall and frequent dry spells, among others cause food scarcity. The challenge faced by small-scale farmers is to enhance water productivity of rainfed agriculture by mitigating intra-seasonal dry spells (ISDS) through the adoption of new technologies such as rainwater harvesting (RWH). The paper analyses the agro-hydrological functions of RWH and assesses its impacts (at field scale) on the crop yield gap as well as the Transpirational Water Productivity ( WPT). The survey in six districts of the semi-arid Zimbabwe suggests that three parameters (water source, primary use and storage capacity) can help differentiate storage-type-RWH systems from “conventional dams”. The Agricultural Production Simulator Model (APSIM) was used to simulate seven different treatments (Control, RWH, Manure, Manure + RWH, Inorganic Nitrogen and Inorganic Nitrogen + RWH) for 30 years on alfisol deep sand, assuming no fertiliser carry over effect from season to season. The combined use of inorganic fertiliser and RWH is the only treatment that closes the yield gap. Supplemental irrigation alone not only reduces the risks of complete crop failure (from 20% down to 7% on average) for all the treatments but also enhances WPT (from 1.75 kg m -3 up to 2.3 kg m -3 on average) by mitigating ISDS.

In 1991, Zimbabwe embarked on a structural adjustment programme. In the health sector, collection of fees was enforced and fees were later increased. Utilisation subsequently declined. This paper examines the perceptions of both government nurses and health care consumers regarding the impact of adjustment on overall quality of care, including nurse professionalism, the nurse-client relationship and patient satisfaction with care. These issues were explored in a series of focus group discussions held in December 1993, about three years after policy reforms. The discussions suggested many areas of shared concern (fees, drug availability, waiting times), but divergent views regarding the process of care. Nurses were concerned mainly with overwork and patient ingratitude, and failed to recognise nurse behaviour as a major source of patient dissatisfaction. Community women saw nurses as hardened and indifferent, especially in urban areas. These differences are rooted in the perceived class differences between nurses and the communities they serve, but appear to have sharpened during the period of structural adjustment. PMID:9447633

Most students taking Geology at the University of Zimbabwe graduate with a B.Sc. General degree. Formerly, the role of this degree was to produce school teachers and until the early 1990s this was the major area of employment. From 1992, the Geology Department changed its curriculum in an effort to make its graduates more marketable. At the same time, the mining industry was expanding. Within a few years the employment situation for the students had dramatically changed — with over three-quarters of the B.Sc. graduates of the last three years finding employment as earth scientists. Students from all three undergraduate years now have more contact with industry, including a vacation placement scheme. University-based curricular changes have included a greater involvement with computers, the economic geology syllabus has been revised and at third-year level the students are now able to drop their second science subject in favour of three vocationally-orientated courses from other faculties. It remains to be seen how successful these curricular changes are in the longer term, without the benefit of a booming industry, but they should form a good basis for the future. Preliminary indications from the mining industry suggest that B.Sc. General graduates have the potential to succeed in basic geological jobs, such as core logging and sampling, which have previously required an Honours degree as a minimum qualification.

Microbial quality of frozen Nile crocodile (Crocodylus niloticus) meat from three farms in Zimbabwe was assessed based on 2051 samples collected for pre-export testing during 2006 to 2011. Data were perused by season and year in terms of aerobic plate (APC), coliform (CC), Escherichia coli (ECC) and Listeria monocytogenes (LMC) counts and the presence of Salmonella spp. The log10-transformed data were compared among the farms and seasons using the Kruskal-Wallis test. Microbial quality of the samples was graded based on the EC No. 2073.2005 criteria for beef. The mean APC and CC for the crocodile meat differed significantly (P=0.000) among the farms with the highest APC (3.2±0.05 log10 cfu/g) and the lowest (2.7±0.05 log10 cfu/g) recorded from farms A and C, respectively. There were no significant differences (P>0.05) in ECC and LMC among the farms, while Salmonella spp. were only isolated from one farm. Although the microbial quality of frozen crocodile meat from these farms was generally within acceptable limits, the isolation of E. coli and Salmonella spp. is of public health concern. Thus, implementing of measures to control the pasteurizing process and to minimize bacterial contamination of crocodile meat after pasteurization need to be carefully considered. PMID:24291179

Malaria is one of the highest contributors to morbidity and mortality in Zimbabwe. However, there is paucity of knowledge regarding disability adjusted life years (DALYs) as a measure of burden of malaria in affected communities. The DALYs metric was used to assess the burden of malaria in Gwanda District with the aim of contributing to a better understanding of the impact of disease on affected communities. Data was collected from health facility malaria registers and the District Health Information System (DHIS) to estimate DALYs at household and district levels respectively. The household DALYs included 130 malaria cases from 2013 to 2015 while the DALYs for the district included 719 confirmed malaria cases from 2011 to 2015. Households lost a total of 153.89 DALYs with the majority of the disease burden (65.55%) occurring in the most economically productive age group (15–45 years) with a mean loss of 1.18 DALYs per malaria case. At district level, 251.09 DALYs were lost due to malaria and the calculated average district DALY rate for 2011–2015 was 36.29 DALYs/100,000 persons per year. It is important to estimate malaria burden to assist policy makers in making informed decisions when channelling resources for control and prevention of the disease. PMID:26907320

The sustainability of donor-funded rural water supply and sanitation projects was assessed in Mbire district, Zimbabwe in terms of level of community participation, quality of implementation and reliability of the systems. The study was carried out through questionnaires, focus group discussions, interviews and field observations. The results show that the quality of implementation of the projects was deemed to be good and participation of the communities in project ideas initiation and choice of technology was found to be very low. Reliability of the systems was found to be very high with 97% of the boreholes in all the three wards studied being functional. Financial management mechanisms were very poor because water consumers were not willing to pay for operation and maintenance. The projects were classified as potentially sustainable with sustainability index between 5.00 and 6.67. Poor financial management mechanisms for effective borehole maintenance, poor quality of construction and lack of community participation in project planning were found to be potential threats to the sustainability of the projects. Future projects should establish the need for the service and should thus be demand driven to ensure effective participation of the water consumers and enhance project's potential for sustainability.

This paper demonstrates how crop diversification impacts on two outcomes of climate smart agriculture; increased productivity (legume and cereal crop productivity) and enhanced resilience (household income, food security, and nutrition) in rural Zimbabwe. Using data from over 500 smallholder farmers, we jointly estimate crop diversification and each of the outcome variables within a conditional (recursive) mixed process framework that corrects for selectivity bias arising due to the voluntary nature of crop diversification. We find that crop diversification depends on the land size, farming experience, asset wealth, location, access to agricultural extension services, information on output prices, low transportation costs and general information access. Our results also indicate that an increase in the rate of adoption improves crop productivity, income, food security and nutrition at household level. Overall, our results are indicative of the importance of crop diversification as a viable climate smart agriculture practice that significantly enhances crop productivity and consequently resilience in rural smallholder farming systems. We, therefore, recommend wider adoption of diversified cropping systems notably those currently less diversified for greater adaptation to the ever-changing climate. PMID:27478752

Social capital—especially through its “network” dimension (high levels of participation in local community groups)—is thought to be an important determinant of health in many contexts. We investigate its effect on HIV prevention, using prospective data from a general population cohort in eastern Zimbabwe spanning a period of extensive behavior change (1998–2003). Almost half of the initially uninfected women interviewed were members of at least one community group. In an analysis of 88 communities, individuals with higher levels of community group participation had lower incidence of new HIV infections and more of them had adopted safer behaviors, although these effects were largely accounted for by differences in socio-demographic composition. Individual women in community groups had lower HIV incidence and more extensive behavior change, even after controlling for confounding factors. Community group membership was not associated with lower HIV incidence in men, possibly refecting a propensity among men to participate in groups that allow them to develop and demonstrate their masculine identities—often at the expense of their health. Support for women's community groups could be an effective HIV prevention strategy in countries with large-scale HIV epidemics. PMID:22066129

During August 2008–June 2009, an estimated 95,531 suspected cases of cholera and 4,282 deaths due to cholera were reported during the 2008 cholera outbreak in Zimbabwe. Despite the efforts by local and international organizations supported by the Zimbabwean Ministry of Health and Child Welfare in the establishment of cholera treatment centres throughout the country, the case-fatality rate (CFR) was much higher than expected. Over two-thirds of the deaths occurred in areas without access to treatment facilities, with the highest CFRs (>5%) reported from Masvingo, Manicaland, Mashonaland West, Mashonaland East, Midland, and Matabeleland North provinces. Some factors attributing to this high CFR included inappropriate cholera case management with inadequate use of oral rehydration therapy, inappropriate use of antibiotics, and a shortage of experienced healthcare professionals. The breakdown of both potable water and sanitation systems and the widespread contamination of available drinking-water sources were also considered responsible for the rapid and widespread distribution of the epidemic throughout the country. Training of healthcare professionals on appropriate cholera case management and implementation of recommended strategies to reduce the environmental contamination of drinking-water sources could have contributed to the progressive reduction in number of cases and deaths as observed at the end of February 2009. PMID:22106761

Gully erosion is an environmental concern particularly in areas where landcover has been modified by human activities. This study assessed the extent to which the potential of gully erosion could be successfully modelled as a function of seven environmental factors (landcover, soil type, distance from river, distance from road, Sediment Transport Index (STI), Stream Power Index (SPI) and Wetness Index (WI) using a GIS-based Weight of Evidence Modelling (WEM) in the Mbire District of Zimbabwe. Results show that out of the studied seven factors affecting gully erosion, five were significantly correlated (p < 0.05) to gully occurrence, namely; landcover, soil type, distance from river, STI and SPI. Two factors; WI and distance from road were not significantly correlated to gully occurrence (p > 0.05). A gully erosion hazard map showed that 78% of the very high hazard class area is within a distance of 250 m from rivers. Model validation indicated that 70% of the validation set of gullies were in the high hazard and very high hazard class. The resulting map of areas susceptible to gully erosion has a prediction accuracy of 67.8%. The predictive capability of the weight of evidence model in this study suggests that landcover, soil type, distance from river, STI and SPI are useful in creating a gully erosion hazard map but may not be sufficient to produce a valid map of gully erosion hazard.

This study documents the use of ethno-veterinary medicine to treat livestock in Nhema communal area in the Midlands province of Zimbabwe. This study employed oral interviews and detailed discussions with 69 smallholder farmers and 3 traditional healers. The local people use 23 plant species belonging to 16 families as ethno-veterinary remedies. Two plant families were particularly frequent in usage: Fabaceae and Solanaceae, while the most utilized plant species were Aloe chabaudii (UV = 0.69), Aloe greatheadii (UV = 0.65), Adenium multiflorum (UV = 0.63), Vernonia amygdalina (UV = 0.61), Nicotiana tabacum (UV = 56), Solanum lycopersicum (UV = 55), Capsicum annum (UV = 53) and Pouzolzia hypoleuca (UV = 51). Fourteen animal conditions were identified in the surveyed area. The major and most common animal diseases were tick-borne diseases, eye problems, retained afterbirth, fleas, lice and diarrhoea. The majority of ethno-veterinary remedies (78%) were collected from the wild, with respondents mostly using herbs (11 species, 48%), followed by 6 trees (26%), 4 shrubs (17%), and 2 climbers (9%). The most frequently used plant parts were leaves (51%), followed by bark (16%), roots (13%) and fruits (10%). These remedies were mostly administered as decoctions or infusions of single plants. These plants were used not only as alternatives to conventional veterinary drugs but also because in certain diseases they were thought to be more efficacious. In view of many and widespread uses of wild plants as ethnoveterinary remedies, further research into their pharmacological activities may prove worthwhile. PMID:23983361

Field research in the relatively unstudied Lower Zambezi trough of northernmost Zimbabwe and adjacent Zambia and Mozambique has revealed a sedimentary tectonic history unlike other Karoo basin (Late Carboniferous to Early Jurassic) of the region. This presents a much better setting for petroleum deposits than has been found in those other areas. Aerial photo interpretation and reconnaissance geophysical data show strike-slip folds and faults at the surface and subbasins up to 10 km deep. This contrast with other Karoo basins, which are of a half-graben genesis, is further evident in the sedimentary sequences of the Lower Zambezi basin complex. Lacustrine turbidites occur in the Lower Karoo Kondo Pools Formation. Upper fan facies of a restricted active margin subaqueous fan system are found in limited outcrops in an accommodation zone uplift between the two subbasins. The overlying units are classical Karoo alluvial layers, but intercalated with a higher frequency of unconformities. Syndepositional and postdepositional deformation includes thrust faulting and detachment. Hydrocarbon potential is enhanced by three virtues that are lacking in other parts of southern Africa. Distal facies to those seen in exposures of the Kondo Pools Formation subaqueous fans should be rich in sapropelic mudstone, the source rock so elusive elsewhere. Second, basin depth is sufficient for thermal maturity. Finally, the tectonic regime was conducive to the formation of convex as well as unconformity traps. Mobil Oil is in the midst of an exploration program that may capitalize on these factors.

To assess the epidemiological features of wildlife rabies in Zimbabwe, a retrospective study covering a period of 12 years (1992-2003) was conducted using rabies records of the Central Veterinary Laboratories (CVL), Department of Veterinary Technical Services at Harare. Records of monthly and annual wildlife rabies were perused with regard to total samples submitted to the CVL and corresponding positive cases. Positive cases were analyzed in relation to the animal species involved, seasonal trends, and land-use categories. A total of 2107 samples were submitted and 1 540 (73.1%) were positive. Jackals (Canis mesomelas and C. adustus), with a peak occurrence of rabies between January and March were the major maintenance host, representing approximately 91% of the total rabies cases confirmed. The Canidae family recorded the highest number of cases followed by the Viverridae, Mustelidae, Felidae, Herpestidae and Hyaenidae families in that order. During the present study rabies cases were confirmed in 7 additional wild animals. The majority of the positive cases (83.7%) were recorded in commercial farming areas in the northeast parts of the country. PMID:18758985

This paper discusses the management of local drinking water supplies in Nkayi, a poor rural district in Zimbabwe. The government policy of rural development has evolved a national sector strategy for water and sanitation, implemented through an Integrated Rural Water Supply and Sanitation (IRWSS) programme 1987-2000, with largely donor funding. One aspect of the programme has seen the construction and upgrading of communally-owned boreholes and deep-wells in villages to allow continuous access to sufficient and safe drinking water within a reasonable walking distance. However, due to dwindling state resources and budgetary constraints, since the 1990s, government has been decentralising service provision to local communities’ including water supply. This paper reveals how eight villages in Nkayi have qualitatively managed to innovatively sustain reliable water supply to continue to meet domestic demand despite the challenges of acute water shortages and the burden of rising maintenance costs due to hyperinflation. Despite an unfavourable economic environment, a unique cost-sharing and resource mobilization process by the community, Nkayi has ensured that 87 per cent of water points remain functional.

Modelling the sedimentation rates using the Wallingford (2004) equations with the aid of NDVI (remote sensing) to assess land degradation was carried out for Malilangwe reservoir catchment in the south eastern lowveld of Zimbabwe. Siltation life of the reservoir was determined from rate of incoming sediment, trap efficiency and reservoir capacity using the Wallingford method. The average rainfall of the study area was about 560 mm while runoff from the catchment ranged from 0.3 mm (minimum) to 199 mm (maximum) with an overall average runoff of 50.03 mm. Results showed that the overall mean annual sediment concentration was approximately 2,400 ppm. The reservoir capacity to inflow ratio was estimated at 0.8 with a sedimentation rate of 120.1 tkm-2 year-1. Calculated probability of the dam filling is 26.8 %. Results also showed that the siltation life of the reservoir was >100 years according to the Wallingford method. The Normalised Difference Vegetation Index (NDVI) showed progressive decline ( p < 0.05) of the vegetation health from 2000 to 2009. While acknowledging the limitations of techniques used, this study demonstrates in part the effectiveness of sedimentation modelling and remote sensing as a tool for the production of baseline data for assessment and monitoring levels of land degradation in the Malilangwe reservoir catchment.

Perennial water problems, precipitated by increased water demand in Bulawayo, the second largest city in Zimbabwe, has prompted the consideration of a wide array of strategies from demand management and water conservation measures to exploitation of alternative water sources. One of such strategies in the latter category includes recycling of blue water for both potable and non-potable purposes. This paper examines the existing reclaimed water system with a view at revamping the existing infrastructure to maximise reclaimed water use for purposes that are amenable to water of lower quality. It is a generally accepted practice to avoid the use of water of high quality for purposes that can tolerate a lower grade, unless it is in excess in amount [ Okun, D.A., 1973. Planning for water reuse. Journal of AWWA 65(10)]. The reclaimed water is assessed in terms of its quality and quantity vis-à-vis possible uses. Perceptions and expectations of both current and identified prospective consumers are examined and discussed, in addition to the feasibility of accommodating these identified prospective consumers in an expanded network. Apart from enhancement of the existing infrastructure, the paper highlights the need for social marketing and education in order to realise the optimum benefits of this alternative water source. The cost implications of implementing the proposed project are evaluated, including suggestions on suitable tariff structure and an allocation distribution that achieves equity.

While the advent of antiretroviral therapy (ART) has increased survival and reduced the number of acquired immune-deficiency syndrome (AIDS) related deaths among people living with the human immunodeficiency virus (HIV) virus (PLHIV), HIV/AIDS remains a global health problem and sub-Saharan Africa continues to bear the greatest burden of disease. There are also major challenges in the HIV response: as of December 2013, only 36% of PLHIV globally were on ART, and for every individual started on ART there were two new PLHIV diagnosed. This has led to considerable debate around adopting an HIV 'treat all' approach aimed at greatly escalating the number of PLHIV initiated and retained on ART, regardless of CD4 cell count or World Health Organization (WHO) clinical stage, with the intended goal of achieving viral suppression which should in turn reduce HIV transmission, morbidity and mortality in affected individuals. This paper examines the issues being discussed in Zimbabwe, a low-income country with a high burden of HIV/AIDS, about the implications and opportunities of adopting an HIV 'treat all' approach, along with pertinent operational research questions that need to be answered to move the agenda forward. These discussions are timely, given the recent WHO recommendations advising ART for all PLHIV, regardless of CD4 cell count. PMID:27051603

Most studies on HIV risk in sub-Saharan Africa focus on individual-level socio-demographic and behavioral correlates of risk. Only recently have researchers and programmers considered the context within which individuals live. This study uses the 2005–6 Zimbabwe Demographic and Health Survey to examine the correlation between the prevalence of HIV at the community level and the prevalence of HIV risk-taking behaviors. Results show that women and men living in communities with higher HIV prevalence in the opposite sex are at increased risk of HIV. In addition, rural women and men living in communities with greater premarital and non-marital sex are at greater risk of HIV. Finally, HIV prevalence is higher among women and men living in urban areas with higher intimate partner violence. Programs should address community-level social norms that make high-risk behaviors acceptable and thus increase all women and men’s risk of HIV, not just those engaged in high-risk behaviors. PMID:22010807

Until recently there has been little, if any, concern over revamping let alone improving wastewater management system in Zimbabwe's urban areas given the dominance and institutionalised water-borne system. Yet, the current constraints in this system and the immensity of urbanisation in the country begs and compels planners, engineers and systems thinkers to rethink what best can work as a sustainable wastewater system. With particular reference to the ever-expanding Harare metropolitan region, this article provides an evaluative analysis on the potentiality, risks and strategies that can be adopted by Harare and its satellites in addressing the problems of the conventional wastewater management system. The suggested framework of operation is a decentralised domestic wastewater collection and treatment system which however has its own multifarious risks. Using systems dynamics conceptualisation of the potentiality, opportunities, risks and strategies, the paper seeks to model the path and outcomes of this decentralised domestic wastewater collection and treatment system and also suggests a number of policy measures and strategies that the city of Harare and its satellites can adopt.

The palynological associations of 16 Karoo samples, collected in the Mana Pools basin, Northern Zimbabwe, were studied, and four zonal assemblages can be recognized. Assemblage I (Kondo Pools Formation) is dominated by monosaccate pollen grains and diverse alete bisaccate pollen grains occur frequently. Important but rare marker genera include Limitisporites, Vittatina and Weylandites. These indicate a middle to late Early Permian age (e.g. Late Sakmarian to Early Artinskian). The palynological assemblage, derived from the Massive Sandstone Member, Angwa Sandstone Formation, is characterized by a small number of smooth and apiculate spores, but is lacking any age significant marker taxa. Assemblages II and III, both from the Alternations Member (Angwa Sandstone Formation), and Assemblage IV (Pebbly Arkose Formation) are dominated by alete bisaccate and multitaeniate pollen grains. The rare occurrence of Vittatina, Weylandites lucifer and Guttulapollenites hannonicus indicates a Late Permian to Early Triassic age for Assemblage II. Based on sedimentological data and literature, a preliminary age of Early Triassic (Induan) can be given. A range from latest Fassanian (Ladinian) to Lacian (Norian) for Assemblage III is indicated by the occurrence of Asseretospora gyrata, Cadargasporites senectus, Eucommiidites, Infernopollenites, Minutosaccus crenulatus, Retisulcites perforatus and Samaropollenites speciosus. Small amounts of Asseretospora gyrata, Cadargasporites senectus, Cycadopites, Microcachryidites and Minutosaccus crenulatus indicate a slightly larger age range for Assemblage IV (e.g. Carnien to Rhaetian).

Adolescence, migration and sex work are independent risk factors for HIV and other poor health outcomes. They are usually targeted separately with little consideration on how their intersection can enhance vulnerability. We interviewed ten women in Zimbabwe who experienced sex work and migration during adolescence, exploring implications for their health and for services to meet their needs. For most, mobility was routine throughout childhood due to family instability and political upheaval. The determinants of mobility, e.g. inability to pay school fees or desire for independence from difficult circumstances, also catalysed entry into sex work, which then led to further migration to maximise income. Respondents described their adolescence as a time of both vulnerability and opportunity, during which they developed survival skills. While these women did not fit neatly into separate risk profiles of "sex worker" "migrant" or "adolescent", the overlap of these experiences shaped their health and access to services. To address the needs of marginalised populations we must understand the intersection of multiple risks, avoiding simplified assumptions about each category. PMID:24791742

Malaria is one of the highest contributors to morbidity and mortality in Zimbabwe. However, there is paucity of knowledge regarding disability adjusted life years (DALYs) as a measure of burden of malaria in affected communities. The DALYs metric was used to assess the burden of malaria in Gwanda District with the aim of contributing to a better understanding of the impact of disease on affected communities. Data was collected from health facility malaria registers and the District Health Information System (DHIS) to estimate DALYs at household and district levels respectively. The household DALYs included 130 malaria cases from 2013 to 2015 while the DALYs for the district included 719 confirmed malaria cases from 2011 to 2015. Households lost a total of 153.89 DALYs with the majority of the disease burden (65.55%) occurring in the most economically productive age group (15-45 years) with a mean loss of 1.18 DALYs per malaria case. At district level, 251.09 DALYs were lost due to malaria and the calculated average district DALY rate for 2011-2015 was 36.29 DALYs/100,000 persons per year. It is important to estimate malaria burden to assist policy makers in making informed decisions when channelling resources for control and prevention of the disease. PMID:26907320

With clear skies most of the year, low levels of light and industrial pollution and location (we can see 96% of the celestial sphere) Zimbabwe is an excellent place for astronomy. For nearly 100 years a small but dedicated and talented band of amateur astronomers have been making hundreds of observations of occultations and variable stars, and contibuted 10% of the global total of reports to the International Halley Watch. The Astronomical Society of Southern Africa (Harare Centre) is 25 years old and the largest telescopes (mostly 'home-made') in the country are owned by members. Active preparations for the next two [in italics] total solar eclipses include site selection, coordination or safaris and free distribution of information packs and over 100 000 eclipse viewers to all [in italics] schools. If the economy doesn't collapse, good government and respect for law and order return, the planes keep flying and fuel shortages end, we look forward to welcoming hundreds of eclipse watchers to a dramatic 3 minute spectacle on 21 June 2001.

The political economy of energy utilization in Zimbabwe's agricultural sector is analyzed. The geography of agricultural energy use is assessed by tracing the articulation of modes of production through time. It is argued that in the production process, labor mediates between humans and the environment. The level of development of the productive forces indicates the intensity that labor applies energy to a given space. Production relations influence the rate and direction of energy flows. Hence, energy is a fundamental component of a mode of production. The linkage between energy use in farming and the articulation of modes of production is made through the conceptualization of distinct agricultural production systems consisting of social relations and productive forces, the relationship to the state, and access to natural resources. After independence came changes in state-peasant relations and industrialization of African production in high potential reserves. Changing social relations on settler farms has caused a rapid displacement of labor by capital at a time when national job creation is dangerously low. In the absence of significant land transfers, a contradictory distribution of agricultural energy resources will continue. New forms of uneven agricultural development are emerging.

The study explores the communication challenges faced by teacher trainees in teaching deaf learners and the opportunities that they present. A critical disabilities study approach within the qualitative paradigm was employed to collect interview data from 14 trainee teachers (6 were men and 8 women) and 5 of their specialist mentors (all of them were women) at 3 special schools in Zimbabwe. The trainees were aged 28-45. Data were analyzed using theme identification methods. Results showed that all the mentors and trainees without deaf assistants tended to teach using spoken language and even though they had no prior experience with them, they were suspicious of the use of deaf assistants, whom they saw as synonymous with sign language. Scepticism about using sign language was based on the idea that it was inadequate, would interfere with spoken language development, and would not enable learners to be included in a nondeaf world. It was also established that most of the mentors and trainees with deaf assistants used spoken language to teach, although this tended to be in combination with signs. Based on these challenges, opportunities to develop the education of deaf learners are discussed and recommendations made. PMID:23109616

In Zimbabwe, more than half of malaria cases are concentrated in Manicaland Province, where seasonal malaria epidemics occur despite intensified control strategies. The objectives of this study were to develop a prediction model based on environmental risk factors and obtain seasonal malaria risk maps for Mutasa District, one of the worst affected districts in Manicaland Province. From October 2012 to September 2015, 483 households were surveyed, and 104 individuals residing within 69 households had positive rapid diagnostic test results. Logistic regression was used to model the probability of household positivity as a function of the environmental covariates extracted from high-resolution remote sensing data sources. Model predictions and prediction standard errors were generated for the rainy and dry seasons. The resulting maps predicted elevated risk during the rainy season, particularly in low-lying areas bordering Mozambique. In contrast, the risk of malaria was low across the study area during the dry season with foci of malaria risk scattered along the northern and western peripheries of the study area. These findings underscore the need for strong cross-border malaria control initiatives to complement country-specific interventions. PMID:27114294

Over the last decade, international donors, technical specialists, and governments have come to recognize the potential of community-based organizations (CBOs) in the fight against HIV/AIDS. Recent empirical studies suggest that community engagement, including the involvement of CBOs, adds value to the national response to HIV/AIDS. With the emerging evidence of the effectiveness of engaging communities in the fight against AIDS, it is crucial to understand the economic dimension of community engagement. This article provides an analysis of funding and expenditure data collected from CBOs in three African countries: Kenya, Nigeria, and Zimbabwe. It presents descriptive information regarding CBO funding and expenditure and examines the factors associated with the total amount of funds received and with the proportions of the funds allocated to programmatic activities and program management and administration. An average CBO in the sample received US$29,800 annually or about US$2480 per month. The highest percentage of CBO funding (37%) came from multilateral organizations. CBOs in the sample spent most of their funds (71%) on programmatic activities including provision of treatment, support, care, impact mitigation, and treatment services. PMID:23745626

Focus group discussions and interviews were held with 40 orphans, 25 caretakers and 33 other community workers from a rural area near Mutare, Zimbabwe. Orphan concerns included feeling different from other children, stress, stigmatization, exploitation, schooling, lack of visits and neglect of support responsibilities by relatives. Many community members, while recognizing their limitations due to poverty, were already actively helping orphans and caretakers. Extended family networks are the primary resource for orphans, though some relatives exploit orphans or fail to fulfil their responsibilities. Interventions are suggested which support community coping mechanisms by strengthening the capacities of families to care for orphans. Outside organizations can develop partnerships with community groups, helping them to respond to the impact of AIDS, by building upon existing concern for orphan families. They can help affected communities to develop orphan support activities which encourage caring responses by community leaders and relatives and which discourage property-grabbing and orphan neglect. Material support channelled through community groups to destitute families at critical times can strengthen family coping mechanisms. Income-generating activities should build upon communities' existing capabilities and benefit the most vulnerable orphan households. Some communities are responding to the AIDS disaster by adaptations to cope with devastating changes taking place in their communities. PMID:9337884

A three-year investigation into the potential use of duckweed based wastewater stabilizations ponds for wastewater treatment was carried out at two small urban areas in Zimbabwe. The study hoped to contribute towards improved environmental management through improving the quality of effluent being discharged into natural waterways. This was to be achieved through the development and facilitation of the use of duckweed based wastewater stabilizations ponds. The study was carried out at Nemanwa and Gutu Growth Points both with a total population of 23 000. The two centers, like more than 70% of Zimbabwe’s small urban areas, relied on algae based ponds for domestic wastewater treatment. The final effluent is used to irrigate gum plantations before finding its way into the nearest streams. Baseline wastewater quality information was collected on a monthly basis for three months after which duckweed ( Lemna minor) was introduced into the maturation ponds to at least 50% pond surface cover. The influent and effluent was then monitored on a monthly basis for chemical, physical and bacteriological parameters as stipulated in the Zimbabwe Water (Waste and Effluent Disposal) regulations of 2000. After five months, the range of parameters tested for was narrowed to include only those that sometimes surpassed the limits. These included: phosphates, nitrates, pH, biological oxygen demand, iron, conductivity, chemical oxygen demand, turbidity, total dissolved solids and total suspended solids. Significant reductions to within permissible limits were obtained for most of the above-mentioned parameters except for phosphates, chemical and biological oxygen demand and turbidity. However, in these cases, more than 60% reductions were observed when the influent and effluent levels were compared. It is our belief that duckweed based waste stabilization ponds can now be used successfully for the treatment of domestic wastewater in small urban areas of Zimbabwe.

Male circumcision (MC) reduces HIV acquisition among men, leading WHO/UNAIDS to recommend a goal to circumcise 80 % of men in high HIV prevalence countries. Significant investment to increase MC capacity in priority countries was made, yet only 5 % of the goal has been achieved in Zimbabwe. The integrated behavioral model (IBM) was used as a framework to investigate the factors affecting MC motivation among men in Zimbabwe. A survey instrument was designed based on elicitation study results, and administered to a representative household-based sample of 1,201 men aged 18-30 from two urban and two rural areas in Zimbabwe. Multiple regression analysis found all five IBM constructs significantly explained MC Intention. Nearly all beliefs underlying the IBM constructs were significantly correlated with MC Intention. Stepwise regression analysis of beliefs underlying each construct respectively found that 13 behavioral beliefs, 5 normative beliefs, 4 descriptive norm beliefs, 6 efficacy beliefs, and 10 control beliefs were significant in explaining MC Intention. A final stepwise regression of the five sets of significant IBM construct beliefs identified 14 key beliefs that best explain Intention. Similar analyses were carried out with subgroups of men by urban-rural and age. Different sets of behavioral, normative, efficacy, and control beliefs were significant for each sub-group, suggesting communication messages need to be targeted to be most effective for sub-groups. Implications for the design of effective MC demand creation messages are discussed. This study demonstrates the application of theory-driven research to identify evidence-based targets for intervention messages to increase men's motivation to get circumcised and thereby improve demand for male circumcision. PMID:24443147

Background Schistosomiasis and STH are among the list of neglected tropical diseases considered for control by the WHO. Although both diseases are endemic in Zimbabwe, no nationwide control interventions have been implemented. For this reason in 2009 the Zimbabwe Ministry of Health and Child Care included the two diseases in the 2009–2013 National Health Strategy highlighting the importance of understanding the distribution and burden of the diseases as a prerequisite for elimination interventions. It is against this background that a national survey was conducted. Methodology A countrywide cross-sectional survey was carried out in 280 primary schools in 68 districts between September 2010 and August 2011. Schistosoma haematobium was diagnosed using the urine filtration technique. Schistosoma mansoni and STH (hookworms, Trichuris trichiura, Ascaris lumbricoides) were diagnosed using both the Kato Katz and formol ether concentration techniques. Main findings Schistosomiasis was more prevalent country-wide (22.7%) than STH (5.5%). The prevalence of S. haematobium was 18.0% while that of S. mansoni was 7.2%. Hookworms were the most common STH with a prevalence of 3.2% followed by A. lumbricoides and T. trichiura with prevalence of 2.5% and 0.1%, respectively. The prevalence of heavy infection intensity as defined by WHO for any schistosome species was 5.8% (range 0%–18.3% in districts). Only light to moderate infection intensities were observed for STH species. The distribution of schistosomiasis and STH varied significantly between provinces, districts and schools (p<0.001). Overall, the prevalence of co-infection with schistosomiasis and STH was 1.5%. The actual co-endemicity of schistosomiasis and STH was observed in 43 (63.2%) of the 68 districts screened. Conclusion and recommendations This study provided comprehensive baseline data on the distribution of schistosomiasis and STH that formed the basis for initiating a national control and elimination programme

This paper compares strains of foot-and-mouth disease (FMD) serotype SAT (South African Territories) 2 viruses isolated from Zimbabwe and other African countries using monoclonal antibodies (MAb). A sandwich-ELISA was used to examine the relative binding of anti-SAT 2 MAb to the various viruses. The MAb-binding profiles of viruses isolated from field samples were compared using hierarchical cluster analysis. Viruses were obtained from game animals, mainly African buffalo (Syncerus caffer) which is the natural host and reservoir for SAT serotypes in Africa, and from cattle showing clinical signs of FMD, as well as from animals suspected of carrying the virus subclinically. Some isolates have been adapted for use as vaccine strains. The results showed that most of the Zimbabwe isolates collected between 1989 and 1992 were an antigenically closely-related group. Although differences were observed between Zimbabwe isolates collected between 1989 and 1992 and those collected in 1987, there was no correlation with the different MAb binding patterns within the 1987 group and the epidemiological information received from the field. Similar profiles were observed for many SAT 2 viruses, including viruses isolated over a 50-year period and from geographically distant areas. This indicates an inherent stability in antigenic profiles of SAT 2 viruses. The MAb panel was capable of assessing antigenic variation, since very different profiles were obtained for some isolates. The work also allowed comparison and characterization of anti-type SAT 2 MAb from different laboratories. The findings are discussed with reference to selection of vaccine strains. PMID:7543860

Background Efforts aimed at reducing maternal mortality as per the Millennium Development Goal 5 (MDG 5) include reducing early childbearing through increased adolescent contraceptive use. Despite a substantial attempt to study factors influencing adolescent contraceptive use in Sub-Saharan Africa (SSA), few studies have explored the role of community level characteristics on adolescent modern contraceptive use. This study examines the influence of both individual, household and community variables in influencing adolescent contraceptive use in Zimbabwe. This study posits that community characteristics are more critical predictors of adolescent contraceptive use in Zimbabwe than other individual and household characteristics. Methods Data from the 2010/11 Zimbabwe Demographic Health Survey (ZDHS), supplemented by additional data from the Measure DHS consultants were used. A total weighted sample of 457 non-pregnant adolescent women aged 15 to 19 years who had their last sex within 12 months preceding the 2010/11 ZDHS was analysed. Univariate, bivariate and multilevel binary logistic regression analysis were performed using generalized linear mixed models (GLMM). Results The odds of contraceptive use were higher for adolescent women with one or more children ever born (Odds Ratio (OR), 13.6) and for those ever married (OR, 2.5). Having medium and high access to media also increased the odds of using contraceptives (OR, 1.8; 2.1 respectively). At community level, the odds of modern contraceptive use decreased with an increase in the mean number of children ever borne per woman (OR, 0.071), an increase in the mean number of school years per women (OR, 0.4) and an increase in the proportion of women with at least secondary education (OR, 0.5). It however increased with an increase in the proportion of women experiencing at least one problem accessing health care (OR, 2.0). Individual and community level variables considered successfully explained the variation of

Teachers are known for their "gate-keeping" roles in schools, especially in the classroom setting. They process and decide what "knowledge" is "valid" and "appropriate" for students. They also decide when and how the knowledge should be mediated to students. Their gate-keeping role marginalizes some forms of knowledge while validating and legitimating others. This qualitative and constructivist-interpretive case study is an exploration and description of ten rural primary school teachers' experiences in teaching science using indigenous perspectives in Zimbabwe. The purpose of the study was to discover and describe, using qualitative inquiry, how teachers incorporate indigenous knowledge and languages in teaching science in a rural primary school in Zimbabwe. The study also sought to understand teachers' mediation techniques in the process of bridging the cultural gap between formal science and indigenous knowledge that students bring into the classroom from home. In this study, I elicited, from teachers, their understanding of the interconnectedness of indigenous knowledge and Western science. I employed qualitative inquiry to collect data from them in their natural working environment, the school and the classroom. Purposive sampling was utilized to select ten teachers who were observed teaching two science lessons each. All the lessons were captured using a video recorder, which facilitated the collection of as much information as possible from events occurring in the classroom. Later, semi-structured interviews/conversations were audio-recorded from the same teachers to elicit their insights and experiences in teaching science using indigenous perspectives and languages. Policy documents and science syllabuses were also perused for information on what teachers were expected to teach in science. Inductive analysis was employed to interpret findings that resulted in thick and in-depth narratives. The findings from these narratives revealed differences and

We analyzed biomarker validation data of unprotected sex from women in Zimbabwe to determine whether condom and sexual behavior misreporting differs between users of different contraceptive methods. Self-reported sexual behavior was compared with the presence of prostate-specific antigen (PSA) in vaginal fluid, a biomarker of semen exposure. Of the 195 women who were PSA positive, 94 (48%) reported no sex or only condom-protected sex. Hormonal contraceptive users misreported sexual behavior less than women using non-hormonal methods (45% vs. 67%, P=0.03). This misclassification pattern could have implications on the elevated risk of HIV infection associated with hormonal contraception in some studies. PMID:24619603

We analyzed biomarker validation data of unprotected sex from women in Zimbabwe to determine whether condom and sexual behavior misreporting differs between users of different contraceptive methods. Self-reported sexual behavior was compared with the presence of prostate-specific antigen (PSA) in vaginal fluid, a biomarker of semen exposure. Of the 195 women who were PSA positive, 94 (48 %) reported no sex or only condom-protected sex. Hormonal contraceptive users misreported sexual behavior less than women using non-hormonal methods (45 vs. 67 %, P = 0.03). This misclassification pattern could have implications on the elevated risk of HIV infection associated with hormonal contraception in some studies. PMID:24619603

The effect of hospital reimbursement systems on the financial management of hospitals is briefly discussed, and the organization of hospital financial operations is reviewed. The implementation of Medicare prospective pricing will change the way in which hospital finances are managed. Health-care managers will be concerned with the profitability of product lines, or diagnosis-related groups, in future strategic planning efforts. The hospital's finance department consists of several traditional areas that exist in almost all financial organizations. The functions and interactions of these various areas are discussed in light of previous and current hospital reimbursement strategies. Staffing of the finance department and the duties of the hospital's chief financial officer are also described. The prospective pricing system of hospital reimbursement and increasing pressure from the business community to stem the rising costs of health care will produce changes in the medical and financial operations of the hospital industry over the next decade. PMID:6375357

This article develops a derived demand for physicians that is general enough to encompass physician control, simple profit maximization and hospital utility maximization models of the hospital. The analysis focuses on three special aspects of physician affiliations: the price of adding a physician to the staff is unobserved; the physician holds appointments at multiple hospitals, and physicians are not homogeneous. Using 1983 American Hospital Association data, a system of specialty-specific demand equations is estimated. The results are consistent with the model and suggest that physicians should be concerned about reduced access to hospitals, particularly as the stock of hospitals declines. PMID:10104050

This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority. PMID:23424818

This research study undertook to find out the perceptions of Bachelor of Education in Physical Education students who are enrolled by the Zimbabwe Open University about their study programme in as far as it empowers them to become effective P.E. practitioners. Its intention was to investigate how these students viewed the ways in which these…

Industrial attachment is a very important component in the learning system particularly for tertiary and higher education as it relates to those who are pursuing careers in commerce. This paper seeks to evaluate the effectiveness of the industrial attachment programme undertaken by the University of Zimbabwe, faculty of commerce. A questionnaire…

The study examined the ODL learners' perceptions of the quality of provision of research support services to the ODL learners by tutors. It focused on the Zimbabwe Open University's (ZOU) Bachelor of Education (Educational Management) research students' experiences. It was a qualitative multiple case study of four of the 10 Regional Centres of the…

Zimbabwe Distance Open University is enrols students from both urban and rural settings. The majority of students living and working in rural areas have limited or no access to computers and electricity as a result the use of information and communication technology (ICT) in the learning process is very limited. Though government has realized the…

The rickettsial bacterium Ehrlichia ruminantium is the causative pathogen of heartwater in ruminants. Here, we report the draft genome sequences of three strains of E. ruminantium, namely, the Crystal Springs strain from Zimbabwe, the Kerr Seringe strain from The Gambia, and the Sankat 430 strain from Ghana. PMID:27313287

Waste management is a major challenge facing urban councils in Zimbabwe and Chinhoyi Municipality is no exception. Lack of resources and technical and administrative know-how is hindering proper waste management. Raw sewage and industrial waste flow into streams and rivers and uncollected rubbish bins and strewn litter is a common feature in the…

This paper examines the teaching and learning of traditional dance at primary school level in Zimbabwe as a key aspect of postcolonial curriculum reimagination within the broader project of reclaiming a nation's heritage. The paper used the survey design to determine how a cohort of primary school teachers understood traditional dance and how they…

Despite the remarkable awareness in Zimbabwe of the importance of Early Childhood Development and Education (ECD), there is insufficient motivation for communities, local authorities and central government to make strategic plans for universal position. The study was to unpack dilemmas and challenges related to the implementation of the ECD…

The study used a phenomenological approach guided by principles of the grounded theory approach to assess the impact of the Global Teenager learning circle on the educational life of students at Mucheke High School, in Zimbabwe. Since in grounded theory, theory comes from the data, the study explored, from students' point of view, how the…

Aim: The aim of this article is to document the risk of neurodevelopmental impairment (NDI) among infants enrolled in a programme for the prevention of mother-to-child transmission of HIV (human immunodeficiency virus) in Zimbabwe using the Bayley Infant Neurodevelopmental Screener (BINS). Method: We prospectively followed up infants at three…

Background: Africa is in an orphan-care crisis. In Zimbabwe, where one-fourth of adults are HIV-positive and one-fifth of children are orphans, AIDS and economic decline are straining society's ability to care for orphans within their extended families. Lack of stable care is putting thousands of children at heightened risk of malnourishment,…

School-Based Assessment (SBA) can help achieve a holistic, child-centred and qualitative account of a pupil's performance. The same method has been criticised for being subjective, informal and open to teacher bias hence the reluctance by the Zimbabwe Schools Examination Council (ZIMSEC) to embrace it for certification and selection into further…

This study sought to examine the quality of teaching practice (TP) mentoring in the teaching of music at primary school level through the distance mode of training at one college of education in Zimbabwe. The study examined the experiences and perceptions of lecturers and student teachers on TP mentoring in music within the context of a distance…

One of the issues that have continued to attract the attention of Open and Distance Learning (ODL) educators, scholars and researchers at the Zimbabwe Open University (ZOU) is the question of quality in the assessment of students' research work. This study was part of a series of studies, into issues of quality, currently being conducted at the…

Religion Education teaching in post-independence Zimbabwe has remained bible-oriented and confessional at a time when most Religion Education stakeholders expect an "open", plural and authentic multi-faith Religion Education curriculum. Despite curriculum innovation initiatives aimed at introducing new approaches such as experiential…

The rickettsial bacterium Ehrlichia ruminantium is the causative pathogen of heartwater in ruminants. Here, we report the draft genome sequences of three strains of E. ruminantium, namely, the Crystal Springs strain from Zimbabwe, the Kerr Seringe strain from The Gambia, and the Sankat 430 strain from Ghana. PMID:27313287

Background Physical and chemical parameters of water in reservoirs can be affected by natural and manmade pollutants, causing damage to the aquatic life and water quality. However, the exact water quality considerations depend on what the water will be used for. Brick making, livestock watering, fisheries, irrigation and domestic uses all have their own specific water quality requirements. In turn, these uses impact on water quality. Methodology Water quality was assessed with a variety of methods in small multipurpose reservoirs in the São Francisco Basin in Brazil, Limpopo in Zimbabwe, Souss Massa in Morocco and Nakambé in Burkina Faso. In each case the first step was to select the reservoirs for which the water quality was to be monitored, then identify the main water uses, followed by a determination of key relevant water quality parameters. In addition, a survey was done in some cases to identify quality perceptions of the users. Samples were taken from the reservoir itself and related water bodies such as canals and wells where relevant. Results Accordingly in the four basins different methods gave different locally relevant results. In the Preto River in the Sao Francisco in Brazil small reservoirs are mainly used for irrigated agriculture. Chemical analysis of various small reservoirs showed that water quality was mainly influenced by geological origins. In addition there was nutrient inflow from surrounding areas of intensive agriculture with high fertilizer use. In the Limpopo basin in Zimbabwe small reservoirs are used for almost all community water needs. Plankton was selected as indicator and sampling was carried out in reservoirs in communal areas and in a national park. Park reservoirs were significantly more diversified in phytoplankton taxa compared to those in the communal lands, but not for zooplankton, though communal lands had the highest zooplankton abundance. In Souss Massa in Morocco a combination of perceptions and scientific water

... this page: //medlineplus.gov/ency/article/000146.htm Hospital-acquired pneumonia To use the sharing features on this page, please enable JavaScript. Hospital-acquired pneumonia is an infection of the lungs ...

The parent of a young child who required major open heart surgery shares his suggestions for coping with a young child's hospitalization including parent visitation, relating to the hospital staff, getting answers to questions, and utilizing available services. (DB)

The Mana Pools and Lower Zambezi Karoo sedimentary basins lie within the Zambezi mobile belt in northern Zimbabwe. The subsurface apparent resistivities measured at both locations are extremely low. Magnetotelluric (MT) data along a profile across part of the Lower Zambezi basin have been inverted using Rapid Relaxation Inversion (Smith & Booker 1991) to find the minimum structure needed to fit the data and compare with an earlier forward model. The resistivity models of both the Mana Pools and the Lower Zambezi basins are then compared with their structure revealed from seismic reflection data. The resistivity structure of the Mana Pools basin is well modelled as a series of different resistivity layers whose boundaries are defined by the seismic data. However, the resistivity structure of the Lower Zambezi basin cannot be matched easily to the seismic structure; additional structure with no seismic expression is required. There is a conductive feature in the two basins in the Upper Karoo sandstone layer that extends below the seismic basement beneath the Lower Zambezi basin. This indicates that the conductors may represent different types of features in the two basins, consistent with their proposed different tectonic origins. A resistive unit is present within the sediments in the Lower Zambezi basin that may represent intercalated basalt dykes, giving an anisotropic MT response. It has been suggested that there might be similar thin basalt layers within the sediments of the Mana Pools basin, but these could not be resolved by MT methods. The low resistivity of the basement, particularly beneath the Lower Zambezi basin, is remarkable and may result from a high degree of either chemical or tectonic alteration to the underlying rocks due to metamorphic processes and tectonic disruption during rift formation. The presence of the Lower Zambezi basin conductor at depths greater than the seismic basement is consistent with observations to the west, in the adjacent

Introduction Gender related vulnerability may increase women's susceptibility to HIV infection and unintended pregnancy. The purpose of the study was to examine the relationship between women empowerment and practices regarding use of dual protection. Methods A non-experimental descriptive correlational study design was conducted using systematic sampling method to recruit eighty women aged 18-49 years at an urban clinic in Zimbabwe. Data was collected using a structured interview schedule and was analysed and presented using descriptive and inferential statistics. Results A weak positive significant correlation existed between women empowerment and use of dual protection (r= .242, p=0.03). Findings demonstrated that as women empowerment levels increase practices regarding use of dual protection also increase. The coefficient of determination, R2=.0.058, b=0.293, indicated that the total amount of variation in utilization of dual protection explained by level of women empowerment was 5.8%. The major finding was that use of dual protection was very low (3.8%) and 67.5% had low levels of practices regarding use of dual protection. Additionally, 85.0% were not confident of using the female condom. Conclusion Gender inequality within sexual relations was associated with low levels of practices regarding use of dual protection. The study provided evidence for the need for a proactive integrated approach to empower women so that they could negotiate for safer sex practices. To increase female condom utilization, manufacturers need to redesign the female condom so that it becomes user friendly. Health personnel need to involve men for any health reproductive program to succeed. PMID:25328596

A cross-sectional study was conducted to investigate seroprevalence of brucellosis and the associated risk factors in cattle from smallholder dairy farms in Gokwe, Marirangwe, Mushagashe, Nharira, Rusitu and Wedza areas of Zimbabwe. A total of 1,440 cattle from 203 herds were tested serially for Brucella antibodies using Rose Bengal test and the competitive ELISA. Weighted seroprevalence estimates were calculated and risk factors in individual cattle investigated using logistic regression analysis. The overall individual animal brucellosis seroprevalence was low, with mean of 5.6% (95% confidence interval (CI), 4.4%, 6.8%). Gokwe had the highest individual (12.6%; 95% CI, 3.9%, 21.4%) and herd-level (40.0%; 95% CI, 22.1%, 58.0%), while Wedza had the lowest individual (2.3%; 95% CI, 0%, 5.3%) and herd-level (8.0%; 95% CI, 0.0%, 18.9%) brucellosis seroprevalence, respectively. In individual cattle, the area of origin, age and history of abortion were independently associated with brucellosis seroprevalence. While the seroprevalence was independent of sex, it decreased with increasing age. Cattle 2-4 years old had higher odds (odds ratio (OR) = 3.2; 95% CI, 1.1%, 9.1%) of being seropositive compared to those >7 years. Cows with a history of abortion were more likely to be seropositive (OR = 7.9; 95% CI, 3.1, 20.1) than controls. In conclusion, the area-to-area variation of brucellosis may be linked to ecological factors and differences in management practices. The implementation of stamping out policy, bleeding and testing animals before movement and promoting the use self-contained units are likely to significantly reduce the public health risks associated with Brucella infections in cattle. PMID:21327714

Background Cash transfer programmes are increasingly recognised as promising and scalable interventions that can promote the health and development of children. However, concerns have been raised about the potential for cash transfers to contribute to social division, jealousy and conflict at a community level. Against this background, and in our interest to promote community participation in cash transfer programmes, we examine local perceptions of a community-led cash transfer programme in Eastern Zimbabwe. Methods We collected and analysed data from 35 individual interviews and three focus group discussions, involving 24 key informants (community committee members and programme implementers), 24 cash transfer beneficiaries, of which four were youth, and 14 non-beneficiaries. Transcripts were subjected to thematic analysis and coding to generate concepts. Results Study participants described the programme as participatory, fair and transparent – reducing the likelihood of jealousy. The programme was perceived to have had a substantial impact on children’s health and education, primarily through aiding parents and guardians to better cater for their children’s needs. Moreover, participants alluded to the potential of the programme to facilitate more transformational change, for example by enabling families to invest money in assets and income generating activities and by promoting a community-wide sense of responsibility for the support of orphaned and vulnerable children. Conclusion Community participation, combined with the perceived impact of the cash transfer programme, led community members to speak enthusiastically about the programme. We conclude that community-led cash transfer programmes have the potential to open up for possibilities of participation and community agency that enable social acceptability and limit social divisiveness. PMID:23587136

The recent development of statistical models such as dynamic site occupancy models provides the opportunity to address fairly complex management and conservation problems with relatively simple models. However, surprisingly few empirical studies have simultaneously modeled habitat suitability and occupancy status of organisms over large landscapes for management purposes. Joint modeling of these components is particularly important in the context of management of wild populations, as it provides a more coherent framework to investigate the population dynamics of organisms in space and time for the application of management decision tools. We applied such an approach to the study of water hole use by African elephants in Hwange National Park, Zimbabwe. Here we show how such methodology may be implemented and derive estimates of annual transition probabilities among three dry-season states for water holes: (1) unsuitable state (dry water holes with no elephants); (2) suitable state (water hole with water) with low abundance of elephants; and (3) suitable state with high abundance of elephants. We found that annual rainfall and the number of neighboring water holes influenced the transition probabilities among these three states. Because of an increase in elephant densities in the park during the study period, we also found that transition probabilities from low abundance to high abundance states increased over time. The application of the joint habitat–occupancy models provides a coherent framework to examine how habitat suitability and factors that affect habitat suitability influence the distribution and abundance of organisms. We discuss how these simple models can further be used to apply structured decision-making tools in order to derive decisions that are optimal relative to specified management objectives. The modeling framework presented in this paper should be applicable to a wide range of existing data sets and should help to address important ecological

Outbreaks of polyarthritis in farmed crocodiles (Crocodylus niloticus) on five farms in Zimbabwe are described. Cases were reported only among the rearing stock aged 1-3 years. No breeding stock suffered. Morbidity was about 10% and the mortality even lower. All the sick animals consistently displayed swollen limb joints as well as progressive lameness and paresis. The synovial structures in subacute cases contained mycoplasmas and excess turbid mucus which, at a later stage of the disease, became yellowish, inspissated and sterile. Cellular changes in the joint capsule included oedema, necrosis of the superficial layers of membrane, lymphocytic infiltration and fibrosis. Evidence of pneumonia was observed only at necropsies. Fifteen isolates of Mycoplasma were cultured from the clinical specimens collected from the four sick and three dead crocodiles. The affected joints of all these animals yielded Mycoplasma in pure culture, but the culture from lungs yielded post-mortem invaders also. The sick animals were treated with a single intramuscular injection of long-acting tetracycline (10 mg/kg), and oxytetracycline mixed in feed at 550 mg/kg was fed for 10 d. The treatment appeared to be effective in ameliorating the clinical signs, but in some cases inflammatory swelling persisted. All 15 the isolates conformed to the characteristics of the genus Mycoplasma, and were serologically indistinguishable in growth-inhibition (Gl) tests. Although these isolates shared the main biochemical characteristics of Mycoplasma capricolum, they differed serologically. Also goats were refractory to experimental infection with crocodile strains. In crocodile yearlings, however, the disease was reproduced with an isolate from one of the affected farms. The source of infection remained elusive.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8539034

Large carnivores are decreasing in number due to growing pressure from an expanding human population. It is increasingly recognised that state-protected conservation areas are unlikely to be sufficient to protect viable populations of large carnivores, and that private land will be central to conservation efforts. In 2000, a fast-track land reform programme (FTLRP) was initiated in Zimbabwe, ostensibly to redress the racial imbalance in land ownership, but which also had the potential to break up large areas of carnivore habitat on private land. To date, research has focused on the impact of the FTLRP process on the different human communities, while impacts on wildlife have been overlooked. Here we provide the first systematic assessment of the impact of the FTLRP on the status of large carnivores. Spoor counts were conducted across private, resettled and communal land use types in order to estimate the abundance of large carnivores, and to determine how this had been affected by land reform. The density of carnivore spoor differed significantly between land use types, and was lower on resettlement land than on private land, suggesting that the resettlement process has resulted in a substantial decline in carnivore abundance. Habitat loss and high levels of poaching in and around resettlement areas are the most likely causes. The FTLRP resulted in the large-scale conversion of land that was used sustainably and productively for wildlife into unsustainable, unproductive agricultural land uses. We recommended that models of land reform should consider the type of land available, that existing expertise in land management should be retained where possible, and that resettlement programmes should be carefully planned in order to minimise the impacts on wildlife and on people. PMID:26819838

Mycotoxins are toxic secondary metabolites produced by filamentous fungi that may contaminate food and pose a health risk, especially in developing countries, where there is a lack of food security and quality is subsumed by food insufficiency. Aflatoxins are the most toxic known mycotoxins and are a significant risk factor for liver and kidney cancer, teratogenicity, undernutrition, and micronutrient malabsorption in both humans and animals. The main aim of the study was to determine the extent of fungal and aflatoxin contamination in peanuts and peanut butter being sold in both the formal and informal markets in Bulawayo, Zimbabwe. Eighteen peanut samples and 11 peanut butter samples were purchased from retail shops and the informal market. Fungal contamination was determined using standard mycology culture methods, while aflatoxin contamination was determined using high-performance liquid chromatography-fluorescence detection. Four of the six peanut samples tested for fungal contamination were infected with Aspergillus flavus/parasiticus, ranging from 3 to 20% of the kernels examined, while 27% (3 of 11) of the peanut butter samples were infected with A. flavus/parasiticus. Ninety-one percent (10 of 11) of the peanut butter samples were contaminated with aflatoxins (mean, 75.66 ng/g, and range, 6.1 to 247 ng/g), and aflatoxin B1 was the most prevalent (mean, 51.0 ng/g, and range, 3.7 to 191 ng/g). Three of the 18 peanut samples were contaminated with aflatoxins (range, 6.6 to 622 ng/g). The commercial peanut butter samples had very high aflatoxin levels, and manufacturers should be sensitized to the detrimental effects of aflatoxins and measures to reduce contamination. PMID:25285504

A study was carried out to determine the distribution and antimicrobial susceptibility profiles of Salmonella serovars from chickens from large-scale commercial (LSC), small-scale commercial (SSC), and rural free-range (RFR) farms of Zimbabwe. Pooled cloacal swabs were collected for culture and isolation of Salmonella spp. A chi-square test was used to assess distribution differences of salmonellas among the farming sectors. Approximately 10% (283/2833) of the swabs were positive for Salmonella enterica, with only subspecies enterica (98.6%) and arizonae (1.4%) being detected. The prevalence of S. enterica varied significantly (P<0.05) among areas, with Harare (27.8%) and Buhera (1.3%) recording the highest and the least prevalence, respectively. S. enterica was only isolated from LSC and SSC farms, with the former having a significantly (P<0.001; χ(2)=155.3) higher prevalence than the latter. S. arizonae was only isolated from the SSC farms while none were obtained from the RFR farms. The serovars isolated were Salmonella Enteritidis (72.8%), Group C (20.1%), Group B (4.2%), Salmonella Typhimurium (1.1%) and Salmonella Gallinarum (0.4%). S. Enteritidis predominated in the urban/periurban areas. Approximately 26% (53/206) of S. Enteritidis isolates were resistant to one or more antimicrobial agents. Resistance to tetracycline was the most common, while no resistance was detected for furazolidone, neomycin and trimethoprim-sulfamethoxazole. There were 12.1% multi-drug-resistant S. Enteritidis isolates, and the resistance to ampicillin/kanamycin was predominant. The identification of multi-drug-resistant S. Enteritidis is of public health concern. Thus, stringent control of S. Enteritidis will reduce the public health risk of human salmonellosis. PMID:22515540

An estimated 70% of the national population lives in rural areas in Zimbabwe. Previous studies suggest that groundwater is consumed predominantly without treatment. This study evaluated the sustainability of a rural water point rehabilitation project that was carried out in Mwenezi (Masvingo Province), and Gwanda, Bulilima and Mangwe (Matabeleland South Province) districts by a local NGO. The study was carried out a year after the rehabilitation project. Sustainability indicators considered in the study included the reliability of the system, human capacity development, institutional arrangements, and the impact of the project on rural livelihoods. A combination of field inspections of the water points and interviews with villagers were used as study tools. It was found out that 14% of the water points were broken down in Mwenezi, 17% (Gwanda), 13% (Bulilima) and 25% (Mangwe). Water quality was satisfactory for taste for over 90% and for 62-95% of respondents for soap consumption in all districts. Trained repair personnel were available in over 50% of the cases. Awareness of the training workshops for operation and maintenance in all districts was above 75%. Water point committees existed and functioned in all districts for 50-83% of water points. For 84-93% of the responses financial contributions were made only in the event of a breakdown. The walking distance to a water point was reduced after the project according to 83-100% of respondents in all districts. Health and hygiene knowledge was deemed to have improved due to the project in 46-78% of cases. It was concluded that opportunities for sustainable water supply are there if active community involvement is enhanced, training is lengthened and water point committees strengthened. There is also need to raise the awareness of ordinary villagers. Future rehabilitation projects should consider stricter supervision and equipping the trained personnel with tools.

Estimates of HIV prevalence computed using data obtained from sampling a subgroup of the national population may lack the representativeness of all the relevant domains of the population. These estimates are often computed on the assumption that HIV prevalence is uniform across all domains of the population. Use of appropriate statistical methods together with population-based survey data can enhance better estimation of national and subgroup level HIV prevalence and can provide improved explanations of the variation in HIV prevalence across different domains of the population. In this study we computed design-consistent estimates of HIV prevalence, and their respective 95% confidence intervals at both the national and subgroup levels. In addition, we provided a multivariable survey logistic regression model from a generalized linear modelling perspective for explaining the variation in HIV prevalence using demographic, socio-economic, socio-cultural and behavioural factors. Essentially, this study borrows from the proximate determinants conceptual framework which provides guiding principles upon which socio-economic and socio-cultural variables affect HIV prevalence through biological behavioural factors. We utilize the 2010–11 Zimbabwe Demographic and Health Survey (2010–11 ZDHS) data (which are population based) to estimate HIV prevalence in different categories of the population and for constructing the logistic regression model. It was established that HIV prevalence varies greatly with age, gender, marital status, place of residence, literacy level, belief on whether condom use can reduce the risk of contracting HIV and level of recent sexual activity whereas there was no marked variation in HIV prevalence with social status (measured using a wealth index), method of contraceptive and an individual’s level of education. PMID:26624280

Estimates of HIV prevalence computed using data obtained from sampling a subgroup of the national population may lack the representativeness of all the relevant domains of the population. These estimates are often computed on the assumption that HIV prevalence is uniform across all domains of the population. Use of appropriate statistical methods together with population-based survey data can enhance better estimation of national and subgroup level HIV prevalence and can provide improved explanations of the variation in HIV prevalence across different domains of the population. In this study we computed design-consistent estimates of HIV prevalence, and their respective 95% confidence intervals at both the national and subgroup levels. In addition, we provided a multivariable survey logistic regression model from a generalized linear modelling perspective for explaining the variation in HIV prevalence using demographic, socio-economic, socio-cultural and behavioural factors. Essentially, this study borrows from the proximate determinants conceptual framework which provides guiding principles upon which socio-economic and socio-cultural variables affect HIV prevalence through biological behavioural factors. We utilize the 2010-11 Zimbabwe Demographic and Health Survey (2010-11 ZDHS) data (which are population based) to estimate HIV prevalence in different categories of the population and for constructing the logistic regression model. It was established that HIV prevalence varies greatly with age, gender, marital status, place of residence, literacy level, belief on whether condom use can reduce the risk of contracting HIV and level of recent sexual activity whereas there was no marked variation in HIV prevalence with social status (measured using a wealth index), method of contraceptive and an individual's level of education. PMID:26624280

Climate Change Adaptation (CCA) and Disaster Risk Reduction (DRR) have similar aims and mutual benefits, and there is a very strong rationale for adopting a more integrated approach to these issues rather than analysing each of them as distinct from the other. One of the gaps that have been noted in this context is the lack of evidence in systematic integration of CCA and DRR in Southern Africa. In this regard, this study builds on understanding CCA and DRR policies from the perspectives of vulnerable groups- women and smallholder farmers, and conducts institutional and policy analysis of CCA and DRR in southern Africa, with specific focus on Malawi and Zimbabwe. Both quantitative and qualitative methodologies were employed to collect data for this study in the two countries. The analysis is centred on the conceptualization of DRR in the context of recovery time and CCA on livelihood changes. Findings of the study show that drought is no longer viewed as a hazard as it is a perennial and chronic occurrence in selected climate hotspots, with heightened intensity in certain identified years. Households are able to quickly recover from slow onset hazards such as droughts and dry spells more than they are able to recover from sudden onset floods, implying more capacity towards CCA than DRR. Government programmes and policies are also focused more on CCA than on DRR efforts that appear not to be a priority. Findings point towards female vulnerability from perceptions and practice where males tend to dominate where they are set to benefit from external assistance. We need to strengthen government capacity in implementation of DRR programmes, which is currently limited and development initiatives must deliberately target building the resilience of women.

ABSTRACT Young women who sell sex (YWSS) in Southern Africa are highly vulnerable to HIV, as the risks of being young and female in a high prevalence setting coalesce with those of commercial sex. YWSS are less able to negotiate safe sex, more likely to have higher risk partners, and less likely to use available health services compared to older sex workers. In Zimbabwe’s national HIV programme for sex workers, fewer than 1% of clients were 15–29. We developed monthly interactive workshops for YWSS based on an Activity Pack consisting of 21 sessions organised into six modules. The aim was to encourage YWSS’ interaction with each other, build their trust, confidence and skills, and encourage uptake of clinical services. We conducted a process evaluation to assess programme strengths, identify challenges, and recommend changes. This paper presents findings synthesising programme records with qualitative data and discusses feasibility, acceptability, and outputs during the pilot phase. In total, 143 YWSS attended meetings and most were from the target 15–19-year-old age group. Participants enjoyed the sessions and reported improved cooperation, willingness to negotiate with clients, and self-reflection about their futures. Staff found facilitating sessions easy and activities clear and appropriate. Challenges included identifying appropriate referrals, initial recruitment of women in some sites, and managing participants’ requests for financial compensation. The number of clients aged 15–19 increased at sex worker clinics in all sites. This programme is the first to target YWSS in Zimbabwe to address their disproportionately low service use. It proved feasible to staff and acceptable to participants over a one-year period. Given enhanced vulnerability of YWSS, this programme provides one workable model for reaching this underserved group. PMID:27391994

ABSTRACT Background: The 14 countries that are scaling up voluntary male medical circumcision (VMMC) for HIV prevention are also considering early infant male circumcision (EIMC) to ensure longer-term reductions in HIV incidence. The cost of implementing EIMC is an important factor in scale-up decisions. We conducted a comparative cost analysis of EIMC performed by nurse-midwives and doctors using the AccuCirc device in Zimbabwe. Methods: Between August 2013 and July 2014, nurse-midwives performed EIMC on 500 male infants using AccuCirc in a field trial. We analyzed the overall unit cost and identified key cost drivers of EIMC performed by nurse-midwives and compared these with costing data previously collected during a randomized noninferiority comparison trial of 2 devices (AccuCirc and the Mogen clamp) in which doctors performed EIMC. We assessed direct costs (consumable and nonconsumable supplies, device, personnel, associated staff training, and waste management costs) and indirect costs (capital and support personnel costs). We performed one-way sensitivity analyses to assess cost changes when we varied key component costs. Results: The unit costs of EIMC performed by nurse-midwives and doctors in vertical programs were US$38.87 and US$49.77, respectively. Key cost drivers of EIMC were consumable supplies, personnel costs, and the device price. In this cost analysis, major cost drivers that explained the differences between EIMC performed by nurse-midwives and doctors were personnel and training costs, both of which were lower for nurse-midwives. Conclusions: EIMC unit costs were lower when performed by nurse-midwives compared with doctors. To minimize costs, countries planning to scale up EIMC should consider using nurse-midwives, who are in greater supply than doctors and are the main providers at the primary health care level, where most infants are born. PMID:27413085

Recent considerations of core thermal conductivity suggest a relatively young (less than 1 billion-year-old) age for the inner core, excluding compositional convection associated with inner core growth as a driving mechanism for an Archean geodynamo. These reconsiderations provide further motivation for studying the nature of the field when core convection was predominantly related to core mantle boundary heat flow. Here we examine the ca. 2.575 Ga Great Dyke of Zimbabwe. We rely on deep drill core samples, eliminating the otherwise pervasive effects of lightning seen in surface samples. We apply single silicate crystal paleointensity (SCP) techniques (Tarduno et al., Rev. Geophys., 2006) on feldspars separated from orthopyroxene gabbros (norites). Scanning electron microscope (SEM) analyses indicate the presence of rare sub-micron equant to slightly elongate magnetic inclusions in the feldspars. The magnetite/titanomagnetite needles commonly observed in feldspars of slowly cooled igneous rocks are rarely observed in crystals from our Great Dyke gabbro samples. Selection criteria of crystals for analyses required feldspar crystals to be free of visible multi-domain inclusions. Natural remanent magnetic intensities of ca. 1 mm-sized feldspar crystal are relatively weak (approximately 1-2 x 10-8 emu), but well within the measurement range of the University of Rochester small bore ultra-high moment resolution 2G DC SQUID magnetometer. Preliminary total thermal demagnetization experiments suggest paleofield values within 50% of those of the present-day, similar to other results that imply a relatively strong magnetic field during the late Archean. Results from Thellier analyses will be used to test this interpretation.

Maize is a key crop contributing to food security in Southern Africa yet accurate estimates of maize yield prior to harvesting are scarce. Timely and accurate estimates of maize production are essential for ensuring food security by enabling actionable mitigation strategies and policies for prevention of food shortages. In this study, we regressed the number of dry dekads derived from VCI against official ground-based maize yield estimates to generate simple linear regression models for predicting maize yield throughout Zimbabwe over four seasons (2009-10, 2010-11, 2011-12, and 2012-13). The VCI was computed using Normalized Difference Vegetation Index (NDVI) time series dataset from the SPOT VEGETATION sensor for the period 1998-2013. A significant negative linear relationship between number of dry dekads and maize yield was observed in each season. The variation in yield explained by the models ranged from 75% to 90%. The models were evaluated with official ground-based yield data that was not used to generate the models. There is a close match between the predicted yield and the official yield statistics with an error of 33%. The observed consistency in the negative relationship between number of dry dekads and ground-based estimates of maize yield as well as the high explanatory power of the regression models suggest that VCI-derived dry dekads could be used to predict maize yield before the end of the season thereby making it possible to plan strategies for dealing with food deficits or surpluses on time.

Background This paper examines the potential for community conversations to strengthen positive responses to HIV in resource-poor environments. Community conversations are an intervention method through which local people work with a facilitator to collectively identify local strengths and challenges and brainstorm potential strategies for solving local problems. Methods We conducted 18 community conversations (with six groups at three points in time) with a total of 77 participants in rural Zimbabwe (20% HIV positive). Participants were invited to reflect on how they were responding to the challenges of HIV, both as individuals and in community groups, and to think of ways to better support openness about HIV, kindness towards people living with HIV and greater community uptake of HIV prevention and treatment. Results Community conversations contributed to local HIV competence through (1) enabling participants to brainstorm concrete action plans for responding to HIV, (2) providing a forum to develop a sense of common purpose in relation to implementing these, (3) encouraging and challenging participants to overcome fear, denial and passivity, (4) providing an opportunity for participants to move from seeing themselves as passive recipients of information to active problem solvers, and (5) reducing silence and stigma surrounding HIV. Conclusions Our discussion cautions that community conversations, while holding great potential to help communities recognize their potential strengths and capacities for responding more effectively to HIV, are not a magic bullet. Poverty, poor harvests and political instability frustrated and limited many participants’ efforts to put their plans into action. On the other hand, support from outside the community, in this case the increasing availability of antiretroviral treatment, played a vital role in enabling communities to challenge stigma and envision new, more positive, ways of responding to the epidemic. PMID:23590640

Colibacillosis, a disease caused by avian pathogenic Escherichia coli (APEC), is one of the main causes of economic losses in the poultry industry worldwide. This study was carried out in order to determine the APEC-associated virulence genes contained by E. coli isolates causing colibacillosis in chickens. A total of 45 E. coli isolates were obtained from the diagnostics and research branch of the Central Veterinary Laboratories, Bulawayo, Zimbabwe. These isolates were obtained from chickens with confirmed cases of colibacillosis after postmortem examination. The presence of the iutA, hlyF, ompT, frz, sitD, fimH, kpsM, sitA, sopB, uvrY, pstB and vat genes were investigated by multiplex polymerase chain reaction (PCR) assay. Of the 45 isolates, 93% were positive for the presence of at least one virulence gene. The three most prevalent virulence genes were iutA (80%), fimH (33.3%) and hlyF (24.4%). The kpsM, pstB and ompT genes had the lowest prevalence, having been detected in only 2.2% of the isolates. All 12 virulence genes studied were detected in the 45 APEC isolates. Virulence gene profiles were constructed for each APEC isolate from the multiplex data. The APEC isolates were profiled as 62.2% fitting profile A, 31.1% profile B and 6.7% profile C. None of the isolates had more than seven virulence genes. Virulence profiles of Zimbabwean APEC isolates are different from those previously reported. Zimbabwean APEC isolates appear to be less pathogenic and may rely on environmental factors and stress in hosts to establish infection. PMID:26017325

Records were collected for Taenia saginata cysticercosis infections in cattle slaughtered at the Cold Storage Company Abattoir in Bulawayo, Zimbabwe, between January 2006 and December 2007. The cattle were drawn from the two Matabeleland provinces in the dry western and southern parts of the country. A total of 86,080 cattle were slaughtered during the period. The average prevalence of T. saginata cysticercosis was found to be 1.6% (n = 1 364) with Matabeleland North having a higher prevalence of 2.8% (n = 629) and Matabeleland South 1.2% (n = 735). There were no significant seasonal differences (p > 0.05) in incidences of T. saginata cysticercosis during the study although numerically, the prevalence of T. saginata cysticercosis was higher in the wet season. There was no significant difference (p > 0.05) in the prevalence of T. saginata cysticercosis in different age classes of cattle slaughtered. Of the infected carcasses, a great proportion of these had live cysts (1.4%) while few had dead cysts (0.2%). Most of the cattle condemned were below the age of 2 years and some were full adults (p < 0.05). There was a significant association between farm type (p < 0.05) and prevalence of T. saginata cysticercosis with most infections being observed in the communal farming system. Though the prevalence of T. saginata cysticercosis appears to be low, there is a need to conscientize the farmers to avoid losses due to carcasses condemnation at slaughter houses which will have a negative financial impact to the individual farmer. There is also a need to investigate such cases even further to reduce zoonotic consequences due to the undetected cases in communal areas. PMID:24429809

Background The Investment Framework for a more effective HIV response has become integral to discussions on how best to respond to the HIV epidemic. The Framework calls for greater synergy and attention to factors that serve as ‘critical enablers’ and optimise HIV programmes. In this paper we argue for recognition of informal and indigenous community groups as ‘critical enablers’ of the HIV response. Methods This qualitative study was conducted in Matobo district of the Matabeleland South province in Zimbabwe. It draws on 19 individual in-depth interviews and 9 focus group discussions conducted by local researchers in September and October 2011. Data was thematically analysed. Results Four core themes highlight the possibilities and limitations of community groups in the HIV response: (i) Membership of indigenous community groups and group-based dialogue were found to encourage group members to engage with HIV prevention, mitigation and care efforts; (ii) local networks and partnerships between groups and NGOs were said to play an important role in accessing much needed resources to aid indigenous coping with AIDS; (iii) community strengths and resources were recognised and drawn upon in the community group response; (iv) frequent droughts, poverty and stigma served as obstacles to an effective HIV response. Conclusions In this context, social groups, although to varying degrees and in direct or indirect ways, play a key role in the HIV response. This suggest that community groups and networks can indeed act as ‘critical enablers’ to the HIV response, and that efforts need to be made to facilitate the contributions of already existing indigenous responses. Local community groups are developing local and collective solutions to structural problems, often independently of external NGO or health service efforts, and begging for synergy and collaboration between local community groups and networks, the health services and other external HIV service delivery

Background: Several nontuberculous mycobacteria (NTM) were previously isolated from diverse environments such as water, soil, sewage, food and animals. Some of these NTM are now known to be opportunistic pathogens of humans. Objective: The main purpose of the study was to identify NTM isolates stored at the National Microbiology Reference Laboratory (NMRL) and were previously isolated from humans during a national tuberculosis (TB) survey. Methods: Pure NTM cultures already isolated from human sputum samples during the national TB survey were retrieved from the NMRL and used for this study. DNA was extracted from the samples and 16S ribosomal RNA gene amplified by polymerase chain reaction. The amplicons were sequenced and bioinformatics tools were used to identify the NTM species. Results: Out of total of 963 NTM isolates stored at the NMRL, 81 were retrieved for speciation. Forty isolates (49.4%) were found to belong to Mycobacterium avium-intracellulare complex (MAC) species. The other 41 isolates (50.6%) were identified as M. lentiflavum (6.2%), M. terrae complex (4.9%), M. paraense (4.9%), M. kansasii (3.7%), M. moriokaense (3.7%), M. asiaticum (2.5%), M. novocastrense (2.5%), M. brasiliensis (2.5%), M. elephantis (2.5%), M. paraffinicum (1.2%), M. bohemicum (1.2%), M. manitobense (1.2%), M. intermedium (1.2%), M. tuberculosis complex (1.2%), M. parakoreense (1.2%), M. florentinum (1.2%), M. litorale (1.2%), M. fluoranthenivorans (1.2%), M. sherrisii (1.2%), M. fortuitum (1.2%) and M septicum (1.2%). Two isolates (2.5%) could not be identified, but were closely related to M. montefiorense and M. phlei respectively. Interestingly, the MAC species were the commonest NTM during the survey. Conclusion: The study emphasizes the importance of identifying species of NTM in Zimbabwe. Future studies need to ascertain their true diversity and clinical relevance. PMID:27335623

Increase in human settlements at the edge of protected areas (PAs) is perceived as a major threat to conservation of biodiversity. Although it is crucial to integrate the interests of surrounding communities into PA management, key drivers of changes in local populations and the effects of conservation on local livelihoods and perceptions remain poorly understood. We assessed population changes from 1990 to 2010 in 9 villages located between 2 PAs with different management policies (access to natural resources or not). We conducted semi-directive interviews at the household level (n =217) to document reasons for settlement in the area and villager's attitudes toward the PAs. We examined drivers of these attitudes relative to household typology, feelings about conservation, and concerns for the future with mixed linear models. Population increased by 61% from 2000 to 2010, a period of political and economic crisis in Zimbabwe. Forty-seven percent of immigrants were attracted by the area; others had been resettled from other villages or were returning to family lands. Attitudes toward PAs were generally positive, but immigrants attracted by the area and who used resources within the PA with fewer restrictions expressed more negative attitudes toward PAs. Household location, losses due to wild animals, and restrictions on access to natural resources were the main drivers of this negative attitude. Profit-seeking migrants did not expect these constraints and were particularly concerned with local overpopulation and access to natural resources. To avoid socio-ecological traps near PAs (i.e., unforeseen reduced adaptive capacity) integrated conservation should address mismatches between management policy and local expectations. This requires accounting for endogenous processes, for example, local socio-ecological dynamics and values that shape the coexistence between humans and wildlife. PMID:23866038

Large carnivores are decreasing in number due to growing pressure from an expanding human population. It is increasingly recognised that state-protected conservation areas are unlikely to be sufficient to protect viable populations of large carnivores, and that private land will be central to conservation efforts. In 2000, a fast-track land reform programme (FTLRP) was initiated in Zimbabwe, ostensibly to redress the racial imbalance in land ownership, but which also had the potential to break up large areas of carnivore habitat on private land. To date, research has focused on the impact of the FTLRP process on the different human communities, while impacts on wildlife have been overlooked. Here we provide the first systematic assessment of the impact of the FTLRP on the status of large carnivores. Spoor counts were conducted across private, resettled and communal land use types in order to estimate the abundance of large carnivores, and to determine how this had been affected by land reform. The density of carnivore spoor differed significantly between land use types, and was lower on resettlement land than on private land, suggesting that the resettlement process has resulted in a substantial decline in carnivore abundance. Habitat loss and high levels of poaching in and around resettlement areas are the most likely causes. The FTLRP resulted in the large-scale conversion of land that was used sustainably and productively for wildlife into unsustainable, unproductive agricultural land uses. We recommended that models of land reform should consider the type of land available, that existing expertise in land management should be retained where possible, and that resettlement programmes should be carefully planned in order to minimise the impacts on wildlife and on people. PMID:26819838

Water use in urban centres is dynamic, fluctuates, differs between high and low-income users, and tends to increase over time. Supply infrastructure can often hardly keep pace with increased water consumption. Given (a) the high cost of infrastructure development, (b) the recent emphasis on demand management, and (c) the social obligation to provide water services to the poor, urban water providers are faced with an important choice: whether to go the demand management route, or to continue constructing new infrastructure. This paper sheds light on some of the possibilities and constraints of both choices by providing a case study of the city of Masvingo in Zimbabwe. The paper analyses water use patterns in this city with a population of 70,000, located in a drought prone region of average rainfall of 600 mm/a. Water consumption has reached the limits of the water supply capacity. The paper first looks at the long-term water use pattern of the city as a whole and the factors that have caused the observed pattern using multiple linear regression. The paper then analyses the patterns of water use of rich and poor households, and attempts to assess the (im)possibilities of influencing these by means of an appropriate tariff structure. In projecting future demand, the paper then considers a number of interventions that could influence demand, which include leakage control, pressure management, awareness campaigns, free technical advice to water users, as well as a new tariff structure. It also discusses when new supply infrastructure should be available, depending on the various demand management measures taken.

The combination of water demand management and cleaner production concepts have resulted in both economical and ecological benefits. The biggest challenge for developing countries is how to retrofit the industrial processes, which at times are based on obsolete technology, within financial, institutional and legal constraints. Processes in closed circuits can reduce water intake substantially and minimise resource input and the subsequent waste thereby reducing pollution of finite fresh water resources. Three industries were studied in Bulawayo, Zimbabwe to identify potential opportunities for reducing water intake and material usage and minimising waste. The industries comprised of a wire galvanising company, soft drink manufacturing and sugar refining industry. The results show that the wire galvanising industry could save up to 17% of water by recycling hot quench water through a cooling system. The industry can eliminate by substitution the use of toxic materials, namely lead and ammonium chloride and reduce the use of hydrochloric acid by half through using an induction heating chamber instead of lead during the annealing step. For the soft drink manufacturing industry water intake could be reduced by 5% through recycling filter-backwash water via the water treatment plant. Use of the pig system could save approximately 12 m 3/month of syrup and help reduce trade effluent fees by Z30/m 3 of “soft drink”. Use of a heat exchanger system in the sugar refining industry can reduce water intake by approximately 57 m 3/100 t “raw sugar” effluent volume by about 28 m 3/100 t “raw sugar”. The water charges would effectively be reduced by 52% and trade effluent fees by Z3384/100 t “raw sugar” (57%). Proper equipment selection, equipment modification and good house-keeping procedures could further help industries reduce water intake and minimise waste.

The University of Zimbabwe College of Health Sciences (UZCHS) is Zimbabwe's premier health professions training institution. However, several concerns were raised during the past decade over the quality of health education at UZCHS. The number of faculty and students declined markedly until 2010, when there was a medical student intake of 147 while the faculty comprised only 122 (39%) of a possible 314 positions. The economic and political crises that the country experienced from 1999 to 2009 compounded the difficulties faced by the institution by limiting the availability of resources. The Medical Education Partnership Initiative (MEPI) funding opportunity has given UZCHS the stimulus to embark on reforms to improve the quality of health education it offers. UZCHS, in partnership with the University of Colorado School of Medicine (UCSOM), the University of Colorado Denver Evaluation Center (UCDEC), and Stanford University designed the Novel Education Clinical Trainees and Researchers (NECTAR) program to implement a series of health education innovations to meet this challenge. Between 2010 and 2013, innovations that have positively affected the quality of health professions education at UZCHS include the launch of comprehensive faculty development programs and mentored clinical and research programs for postgraduate students. A competency-based curriculum reform process has been initiated; a health professions department has been established; and the Research Support Center has been strengthened, providing critical resources to institutionalize health education and research implementation at the college. A core group of faculty trained in medical education has been assembled, helping to ensure the sustainability of these NECTAR activities. PMID:25072588

Setting: In Zimbabwe, there are concerns about the management of tuberculosis (TB) patients with rifampicin (RMP) resistance diagnosed using Xpert® MTB/RIF. Objective: To assess linkages between diagnosis and treatment for these patients in Harare and Manicaland provinces in 2014. Design: A retrospective cohort study. Results: Of 20 329 Xpert assays conducted, 90% were successful, 11% detected Mycobacterium tuberculosis and 4.5% showed RMP resistance. Of 77 patients with RMP-resistant TB diagnosed by Xpert, 70% had samples sent to the reference laboratory for culture and drug susceptibility testing (CDST); 53% of the samples arrived. In 21% the samples showed M. tuberculosis growth, and in 17% the DST results were recorded, all of which confirmed RMP resistance. Of the 77 patients, 34 (44%) never started treatment for multidrug-resistant (MDR) TB, with documented reasons being death, loss to follow-up and incorrect treatment. Of the 43 patients who started MDR-TB treatment, 12 (71%) in Harare and 17 (65%) in Manicaland started within 2 weeks of diagnosis. Conclusion: Xpert has been rolled out successfully in two Zimbabwe provinces. However, the process of confirming CDST for Xpert-diagnosed RMP-resistant TB works poorly, and many patients are either delayed or never initiate MDR-TB treatment. These shortfalls must be addressed at the programmatic level. PMID:27358806

This article focuses on factors affecting elementary female student teachers' choice of science as a major at college level in Zimbabwe. In Sub-Saharan Africa, there has been an unprecedented expansion in education in the last 2 decades. This reflects the broad recognition that education contributes to national development. This expansion has not been matched with equal access and opportunity to education. The education of females still lags behind that of males in most developing countries, and in Sub-Saharan Africa in particular (Hyde, 1989). Fewer girls than boys study science at both secondary and college levels. The study took place in Zimbabwe at Mkoba Teachers' College. Two groups of elementary female student teachers participated in the study, namely science majors and nonscience majors. Ten science majors and nine nonscience majors took part in individual interviews. For focus group interviews, there were three groups of six each from science and nonscience majors. The study was conducted between May 2004 and July 2004. Out-of-school experiences, culture, and attitudes toward science emerged as factors affecting female student teachers' choice of science as a major. A number of implications have been discussed as well as suggestions for further research. Limitations of the study have been analyzed as well.

Health-related quality of life (HRQoL) is a broad concept reflecting a patient's general subjective perception of the effect of an illness or intervention on physical, psychological and social aspects of their daily life. HRQoL among patients infected with HIV has become an important indicator of impact of disease and treatment outcomes. A cross-sectional survey was carried out at Chitungwiza Central Hospital, Zimbabwe, to assess HRQoL in patients with HIV/AIDS receiving antiretroviral therapy (ART), using two validated instruments. The HIV/AIDS-targeted quality of life (HAT-QoL) and EuroQoL Five-dimensions-Three-level (EQ-5D-3L) instruments were used to assess HRQoL. Internal consistency reliability and convergent validity of the two instruments were also evaluated. For construct validity, the relationships between HRQoL scores and socio-economic and HIV/AIDS-related characteristics were explored. The median scores for the HAT-QoL dimensions ranged from 33.3 (financial worries) to 100 (HIV mastery). A considerably low HAT-QoL dimension score of 50.0 was observed for sexual function. There were ceiling effects for all HAT-QoL dimension scores except for financial worries and disclosure worries. Floor effects were observed for financial worries and sexual function. The median of the EQ-5D-3L index and visual analogue scale (VAS) was 0.81 and 79.0, respectively. There were no floor or ceiling effects for both the EQ-5D-3L index and VAS. The overall scale Cronbach's alpha was 0.83 for HAT-Qol and 0.67 for EQ-5D-3L. HAT-QoL demonstrated good convergent validity with EQ-5D index (0.58) and VAS (0.40). A higher level of HRQoL was positively and significantly related to income, education and employment. The patients' self-reported HRQoL was generally satisfactory in all the HAT-QoL dimensions as well as the two components on the EQ-5D-3L instrument. The two instruments demonstrated good measurement properties in HIV/AIDS patients receiving ART and have potential for use

New findings on Gyrodactylus spp. parasitising African cichlids in southern Africa are presented, comprising data from Zimbabwe and South Africa. Morphometry of opisthaptoral hard parts in combination with nuclear ribosomal DNA sequences confirmed the presence of six species of Gyrodactylus von Nordmann, 1832. Three new species are described from fishes in Zimbabwe: Gyrodactylus chitandiri n. sp. from the gill arches of Coptodon rendalli (Boulenger) and Pseudocrenilabrus philander (Weber); Gyrodactylus occupatus n. sp. from the fins of Oreochromis niloticus (L.), Pharyngochromis acuticeps (Steindachner) and P. philander; and Gyrodactylus parisellei n. sp. from the fins of O. niloticus, P. philander and Tilapia sp. Gyrodactylus nyanzae Paperna, 1973 was also identified from the gills of O. niloticus and C. rendalli collected from two localities in Zimbabwe; these findings represent new host and locality records for this parasite. Gyrodactylus sturmbaueri Vanhove, Snoeks, Volckaert & Huyse, 2011 was identified from P. philander collected in South Africa and Zimbabwe thereby providing new host and locality records for this parasite. Finally, Gyrodactylus yacatli García-Vásquez, Hansen, Christison, Bron & Shinn, 2011 was collected from the fins of O. niloticus and P. philander studied in Zimbabwe; this represents the first record of this species from the continent of Africa. Notably, this study improves upon the knowledge of Gyrodactylus spp. parasitising cichlids from these southern African regions. All species studied were recorded from at least two different cichlid host species indicating trend for a wide range of Gyrodactylus hosts in Africa. Accordingly, this supports the idea of intensive host switching in the course of their evolution. PMID:27522367

Introduction Children living with HIV experience particular challenges in accessing HIV care. Children usually rely on adult caregivers for access to care, including timely diagnosis, initiation of treatment and sustained engagement with HIV services. The aim of this study was to inform the design of a community-based intervention to support caregivers of HIV-positive children to increase children's retention in care as part of a programme introducing decentralized HIV care in primary health facilities. Methods Using an existing conceptual framework, we conducted formative research to identify key local contextual factors affecting children's linkages to HIV care in Harare, Zimbabwe. We conducted semi-structured interviews with 15 primary caregivers of HIV-positive children aged 6–15 years enrolled at a hospital clinic for at least six months, followed by interviews with nine key informants from five community-based organizations providing adherence support or related services. Results We identified a range of facilitators and barriers that caregivers experience. Distance to the hospital, cost of transportation, fear of disclosing HIV status to the child or others, unstable family structure and institutional factors such as drug stock-outs, healthcare worker absenteeism and unsympathetic school environments proved the most salient limiting factors. Facilitators included openness within the family, availability of practical assistance and psychosocial support from community members. Conclusions The proposed decentralization of HIV care will mitigate concerns about distance and transport costs but is likely to be insufficient to ensure children's sustained retention. Following this study, we developed a package of structured home visits by voluntary lay workers to proactively address other determinants such as disclosure within families, access to available services and support through caregivers’ social networks. A randomized controlled trial is underway to

2. View northwest of main hospital building complex, hospital building (Building 90), administration and clinical hospital building (Building 88), and hospital building (Building 91) - National Home for Disabled Volunteer Soldiers Western Branch, 4101 South Fourth Street, Leavenworth, Leavenworth County, KS

To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger. PMID:25223156

Background HIV has left many African children caring for sick relatives, orphaned or themselves HIV-positive, often facing immense challenges in the absence of significant support from adults. With reductions in development funding, public sector budgetary constraints, and a growing emphasis on the importance of indigenous resources in the HIV response, international policy allocates schools a key role in ‘substituting for families’ (Ansell, 2008) in supporting child health and well-being. We explore children’s own accounts of the challenges facing their HIV-affected peers and the role of schools in providing such support. Methods Contextualised within a multi-method study of school support for HIV-affected children in rural Zimbabwe, and regarding children’s views as a key resource for child-relevant intervention and policy, 128 school children (10–14) wrote a story about an HIV-affected peer and how school assisted them in tackling their problems. Results Children presented harrowing accounts of negative impacts of HIV on the social, physical and mental well-being of peers, and how these manifested in the school setting. Whilst relationships with fellow learners and teachers were said to provide a degree of support, this was patchy and minimal, generally limited to small-scale and often one-off acts of material help or kindness (e.g. teachers giving children pens and exercise books or peers sharing school lunches), with little potential to impact significantly on the wider social drivers of children’s daily challenges. Despite having respect for the enormity of the challenges many HIV-affected peers were coping with, children tended to keep a distance from them. School was depicted as a source of the very bullying, stigma and social exclusion that undermined children’s opportunities for well-being in their lives more generally. Conclusions Our findings challenge glib assumptions that schools can serve as a significant ‘indigenous’ supports of

Background A paradigm shift in global health policy on user fees has been evident in the last decade with a growing consensus that user fees undermine equitable access to essential health care in many low and middle income countries. Changes to fees have major implications for human resources for health (HRH), though the linkages are rarely explicitly examined. This study aimed to examine the inter-linkages in Zimbabwe in order to generate lessons for HRH and fee policies, with particular respect to reproductive, maternal and newborn health (RMNH). Methods The study used secondary data and small-scale qualitative fieldwork (key informant interview and focus group discussions) at national level and in one district in 2011. Results The past decades have seen a shift in the burden of payments onto households. Implementation of the complex rules on exemptions is patchy and confused. RMNH services are seen as hard for families to afford, even in the absence of complications. Human resources are constrained in managing current demand and any growth in demand by high external and internal migration, and low remuneration, amongst other factors. We find that nurses and midwives are evenly distributed across the country (at least in the public sector), though doctors are not. This means that for four provinces, there are not enough doctors to provide more complex care, and only three provinces could provide cover in the event of all deliveries taking place in facilities. Conclusions This analysis suggests that there is a strong case for reducing the financial burden on clients of RMNH services and also a pressing need to improve the terms and conditions of key health staff. Numbers need to grow, and distribution is also a challenge, suggesting the need for differentiated policies in relation to rural areas, especially for doctors and specialists. The management of user fees should also be reviewed, particularly for non-Ministry facilities, which do not retain their revenues

Natural forests are threatened worldwide, therefore their protection in National Parks is essential. Here, we investigate how this protection status affects the land cover. To answer this question, we analyse the surface reflectance of three Landsat images of Matobo National Park and surrounding in Zimbabwe from 1989, 1998 and 2014 to detect changes in land cover in this region. To account for the rolling countryside and the resulting prominent shadows, a topographical correction of the surface reflectance was required. To infer land cover changes it is not only necessary to have some ground data for the current satellite images but also for the old ones. In particular for the older images no recent field study could help to reconstruct these data reliably. In our study we follow the idea that land cover classes of pixels in current images can be transferred to the equivalent pixels of older ones if no changes occurred meanwhile. Therefore we combine unsupervised clustering with supervised classification as follows. At first, we produce a land cover map for 2014. Secondly, we cluster the images with clara, which is similar to k-means, but suitable for large data sets. Whereby the best number of classes were determined to be 4. Thirdly, we locate unchanged pixels with change vector analysis in the images of 1989 and 1998. For these pixels we transfer the corresponding cluster label from 2014 to 1989 and 1998. Subsequently, the classified pixels serve as training data for supervised classification with random forest, which is carried out for each image separately. Finally, we derive land cover classes from the Landsat image in 2014, photographs and Google Earth and transfer them to the other two images. The resulting classes are shrub land; forest/shallow waters; bare soils/fields with some trees/shrubs; and bare light soils/rocks, fields and settlements. Subsequently the three different classifications are compared and land changes are mapped. The main changes are

Background There are an estimated half-million children living with HIV in sub-Saharan Africa. The predominant source of infection is presumed to be perinatal mother-to-child transmission, but general population data about paediatric HIV are sparse. We characterise the epidemiology of HIV in children in sub-Saharan Africa by describing the prevalence, possible source of infection, and effects of paediatric HIV in a southern African population. Methods From 2009 to 2011, we conducted a household-based survey of 3389 children (aged 2–14 years) in Manicaland, eastern Zimbabwe (response rate: 73.5%). Data about socio-demographic correlates of HIV, risk factors for infection, and effects on child health were analysed using multi-variable logistic regression. To assess the plausibility of mother-to-child transmission, child HIV infection was linked to maternal survival and HIV status using data from a 12-year adult HIV cohort. Results HIV prevalence was (2.2%, 95% CI: 1.6–2.8%) and did not differ significantly by sex, socio-economic status, location, religion, or child age. Infected children were more likely to be underweight (19.6% versus 10.0%, p = 0.03) or stunted (39.1% versus 30.6%, p = 0.04) but did not report poorer physical or psychological ill-health. Where maternal data were available, reported mothers of 61/62 HIV-positive children were deceased or HIV-positive. Risk factors for other sources of infection were not associated with child HIV infection, including blood transfusion, vaccinations, caring for a sick relative, and sexual abuse. The observed flat age-pattern of HIV prevalence was consistent with UNAIDS estimates which assumes perinatal mother-to-child transmission, although modelled prevalence was higher than observed prevalence. Only 19/73 HIV-positive children (26.0%) were diagnosed, but, of these, 17 were on antiretroviral therapy. Conclusions Childhood HIV infection likely arises predominantly from mother-to-child transmission and is

Background Prominent ear is the most common congenital ear deformity affecting 5% of children in the Western world and has profound psychosocial effects on the bearer. It is important to know the prevalence in the local population to have a better appreciation of the local burden of the abnormality as well as to know the parameters of ear morphology locally. These parameters can be useful in the diagnosis and evaluation of ear anomalies and may help reconstructive surgeons in reproducing an anatomically correct ear of an African/Zimbabwean child. Objectives To evaluate the frequency of prominent ears in black school going children in Zimbabwe and to establish morphometric properties of the ear. Design Prospective observational, cross sectional study. Setting Three Primary schools in Harare. Two in a high density area and one in a low density area. Materials and methods Three Primary schools in Harare were selected at random. The following measurements were taken: ear lengths, ear projection and face height using a sliding caliper. Three hundred and five healthy pupils of the age range 9–13 years of both sexes were included in the study, whilst children with congenital anomalies, ear tumours and history of ear trauma were excluded. Results The mean ear height across the cohort was 56.95 ± 5.00 (right ear) and 56.86 ± 4.92 (left ear). Ear projection was 19.52 ± 2.14 (right ear) and 19.59 ± 2.09 (left ear). Gender related differences were noted. Mean ear height was significantly higher in males (p-value = 0.000). Ear projection was higher in males compared to females. A total of 6.89% had prominent ears. Among males, 7.69% had prominent ears whilst 6.17% of females had prominent ears. Conclusion The prevalence of prominent ear among black African children in the studied population is comparable to that of Caucasians. The study provides a set of biometric data of auricular dimensions for normal black African children aged 9–13 years. PMID:26468372

Lack of basic sanitation systems threaten environmental and human health in low income urban communities. In 2005, the Government of Zimbabwe carried out a cleanup exercise in urban areas involving the destruction of illegal structures which left many people homeless. As a solution to this problem, the government embarked on an extensive housing construction exercise on unserviced land; the ‘Garikai/Hlalani Kuhle’ development programme. The objective of this paper was to investigate the sanitation status in one such area (Cowdray Park Extension, Bulawayo) and determine a sustainable sanitation system for the improved collection of wastewater from the unserviced low income urban area. The study was carried out between October 2010 and February 2011. The sanitation status as well as the residents’ preferences for improved sanitation and the economic set up of the community for the study area was determined through use of questionnaires to the residents. The local authority was then consulted to recommend sanitation facilities and system for the area that met regulatory requirements. A literature study identified sanitation options that were applicable to low income and high density urban areas. The baseline survey found that 61% of the people in the study area lacked sanitation facilities and practiced open defecation. The majority of the residents (70%) preferred ‘flush and discharge’ system sanitation facilities, which was in line with the local council’s requirements. On-site sanitation options were found not to be feasible as per the council regulations and the findings of the literature study, for areas with a high density of houses. Therefore a sewerage system was designed using the conventional sewerage design approach as well as the simplified sewerage design approach in order to determine the collection system that would best meet the needs of the community. In conclusion, the community was in dire need of a sanitation system and a waterborne

Small dams in Mzingwane Catchment in southern Zimbabwe are mostly in poor physical condition mainly due to lack of resources for repair and maintenance. Most of these dams are likely to fail thereby adversely affecting water availability and livelihoods in the area. To assist those involved in maintenance, repair and rehabilitation of small dams in resource poor and data sparse areas such as Mzingwane Catchment, a non-probabilistic but numerical risk of failure evaluation tool was developed. The tool helps to systematically, and objectively classify risk of failure of small dams, hence assist in the ranking of dams to prioritise and attend to first. This is important where resources are limited. The tool makes use of factors such as seepage, erosion and others that are traditionally used to assess condition of dams. In the development of the tool, an assessment of the physical condition of 44 (1 medium sized and 43 small dams) dams was done and the factors were identified and listed according to guidelines for design and maintenance of small dams. The description of the extent to which the factors affect the physical condition of small dams was then standardised. This was mainly guided by standard based and risk-based approaches to dam safety evaluation. Cause-effect diagrams were used to determine the stage at which each factor is involved in contributing to dam failure. Weights were then allocated to each factor depending on its stage or level in the process of causing dam failure. Scores were allocated to each factor based on its description and weight. Small dams design and maintenance guidelines were also used to guide the ranking and weighting of the factors. The tool was used to classify 10 dams. The risk of failure was low for one dam, moderate for one, high for four and very high for four dams, two of which had already failed. It was concluded that the tool could be used to rank the risk of failure of small dams in semi-arid areas. The tool needs to be

Introduction Zimbabwe has reported significant declines in HIV prevalence between 2005/06 and 2010/11 Demography and Health Surveys; a within-gender analysis to identify the magnitude and factors associated with this change, which can be masked, is critical for targeting interventions. Methods We analyzed change in HIV prevalence for 6,947 women and 5,848 men in the 2005/06 survey and 7,313 women and 6,250 men in 2010/11 surveys using 2005/06 as referent. The data was analyzed taking into consideration the survey design and therefore the svy, mean command in Stata was used in both linear and logistic regression. Results There were similar proportional declines in prevalence at national level for males (15% p=0.011) and females (16%,p=0.008). However, there were variations in decline by provincial setting, demographic variables of age, educational level and some sexual risk behaviours. In logistic regression analysis, statistically significant declines were observed among men in Manicaland, Mashonaland East and Harare (p<0.01) and for women in Manicaland, Mashonaland Central and Harare (p<0.01). Although not statistically significant, numerical increases were observed among men in Matebeleland North, Matebeleland South, Midlands and for both men and women in Bulawayo. Young women in the age range 15-34 experienced a decline in prevalence (p<0.01) while older men 30-44 had a statistically significant decline (p<0.01). Having a secondary and above education, regardless of employment status for both men and women recorded a significant decline. For sexual risk behaviours, currently in union for men and women and not in union for women there was a significant decline in prevalence. Conclusion Zimbabwe has reported a significant decline among both men and women but there are important differentials across provinces, demographic characteristics and sexual risk behaviours that suggest that the epidemic in Zimbabwe is heterogeneous and therefore interventions must be

ABSTRACT Background: Zimbabwe, like most low-income countries, faces health worker shortages. Community health workers (CHWs) bridge this gap by delivering essential health services and nutrition interventions to communities. However, as workloads increase, CHWs’ ability to provide quality services may be compromised. We studied influences upon CHWs’ performance related to pregnancy surveillance and nutrition and hygiene education in rural Zimbabwe. Methods: In the context of a cluster-randomized trial conducted in 2 rural districts between November 2012 and March 2015, 342 government-employed CHWs identified and referred pregnant women for early antenatal care and delivered household-level behavior change lessons about infant feeding and hygiene to more than 5,000 women. In 2013, we conducted a survey among 322 of the CHWs to assess the association between demographic and work characteristics and task performance. Exploratory factor analyses of the Likert-type survey questions produced 8 distinct and reliable constructs of job satisfaction and motivation, supervision, peer support, and feedback (Cronbach α range, 0.68 to 0.92). Pregnancy surveillance performance was assessed from pregnancy referrals, and nutrition and hygiene education performance was assessed by taking the average summative score (range, 5 to 30) of lesson delivery observations completed by a nurse supervisor using a 6-item Likert-type checklist. Poisson and multiple linear regressions were used to test associations between CHW demographic and work characteristics and performance. Results: CHWs who referred more pregnant women were female, unmarried, under 40 years old, from larger households, and of longer tenure. They also perceived work resources to be adequate and received positive feedback from supervisors and the community, but they were less satisfied with remuneration. CHWs with high scores on behavior change lesson delivery were from smaller households, and they received more

Stakeholder participation is viewed as critical in the current water sector reforms taking place in the Southern African region. In Zimbabwe, policies and legislation encourage stakeholder participation. A study was undertaken to determine the extent of stakeholder participation in water quality monitoring and surveillance at the operational level, and also to assess indigenous knowledge and practices in water quality monitoring. Two hundred and forty one questionnaires were administered in Mzingwane Catchment, the portion of the Limpopo Basin that falls within Zimbabwe. The focus was on small users in rural communities, whose experiences were captured using a questionnaire and focus group discussions. Extension workers, farmers and NGOs and relevant sector government ministries and departments were also interviewed and a number of workshops held. Results indicate that there is very limited stakeholder participation despite the presence of adequate supportive structures and organisations. For the Zimbabwe National Water Authority (ZINWA), stakeholders are the paying permit holders to whom feedback is given following analysis of samples. However, the Ministry of Health and Child Welfare generally only releases information to rural communities when it is deemed necessary for their welfare. There are no guidelines on how a dissatisfied member of the public can raise a complaint - although some stakeholders carry such complaints to Catchment Council meetings. With regard to water quality, the study revealed widespread use of indigenous knowledge and practice by communities. Such knowledge is based on smell, taste, colour and odour perceptions. Residents are generally more concerned about the physical parameters than the bacteriological quality of water. They are aware of what causes water pollution and the effects of pollution on human health, crops, animals and aquatic ecology. They have ways of preventing pollution and appropriate interventions to take when a source

The Choma-Kalomo Block is a north-east trending, Mesoproterozoic terrane located in southern Zambia. It is composed of as yet undated gneissic basement with a high-grade metamorphosed supracrustal metasedimentary sequence, which is intruded by hornblende granites and gneisses of the Choma-Kalomo Batholith, that is dated between ca. 1.37 and 1.18 Ga. Our new zircon U-Pb age data on metasedimentary rocks of the Choma-Kalomo Block identifies samples of different ages, with slightly different provenances. The oldest metasedimentary rock is a muscovite-biotite schist, which has only Palaeoproterozoic detrital zircons, the two age clusters around 2.03-2.02 Ga and 1.8-1.9 Ga, correspond to the ages of granitic intrusion, and metamorphism, in the Magondi Mobile Belt on the western side of the Archaean Zimbabwe Craton. The second sample is a garnetiferous paragneiss, which contains both Palaeoproterozoic (2.04 Ga), and Mesoproterozoic zircons, ca. 1.36 Ga, derived from the granites of the Choma-Kalomo Batholith. The third sample is a biotite-muscovite schist, in which the detrital zircon ages fall into four separate clusters: ca. 3.39 Ga, ca. 2.7-2.6 Ga, ca. 2.1-1.7 Ga (with a peak at ca. 1.18 Ga), and 1.55 - 1.28 Ga. The Archaean zircons in this sample are derived from the Zimbabwe Craton, while the Palaeoproterozoic samples come from the Magondi belt, and the youngest zircons come from both phases of the Choma-Kalomo Batholith. A possible connection between the Choma-Kalomo Block and the Dete-Kamativi Inlier - some 150 km to the south-east in western Zimbabwe - has been proposed on the basis of similarities in the nature of their Sn-Ta-muscovite pegmatite mineralisation. The Dete-Kamativi Inlier, which is part of the Magondi Mobile Belt, is a window into Palaeoproterozoic north-east trending belts of deformed and metamorphosed supracrustal rocks. By dating localities which we suspect form the basement to the surrounding younger sediments, along with selected pegmatites

This study presents a comprehensive method for quantifying hospital output and estimating hospital productivity. A number of less comprehensive productivity measures that can be quantified from data available from regional third-party payers and from the American Hospital Association are also developed and evaluated as proxies for the comprehensive measure, which is based on local area data. Methods are discussed for estimating the necessary variables on a regional or national level. PMID:4461703

The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial is designed to measure the independent and combined effects of improved water, sanitation, and hygiene and improved infant feeding on child stunting and anemia in Zimbabwe. We developed and pilot-tested the infant feeding intervention delivered by 9 village health workers to 19 mothers of infants aged 7-12 months. Between September 2010 and January 2011, maternal knowledge was assessed using mixed methods, and infant nutrient intakes were assessed by 24-hour recall. We observed positive shifts in mothers' knowledge. At baseline, 63% of infants met their energy requirement and most did not receive enough folate, zinc, or calcium; none met their iron requirement. Postintervention, all infants received sufficient fat and vitamin A, and most consumed enough daily energy (79%), protein (95%), calcium (89%), zinc (89%), folate (68%), and iron (68%). The SHINE trial infant feeding intervention led to significant short-term improvements in maternal learning and infant nutrient intakes. PMID:26602298

The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial is designed to measure the independent and combined effects of improved water, sanitation, and hygiene and improved infant feeding on child stunting and anemia in Zimbabwe. We developed and pilot-tested the infant feeding intervention delivered by 9 village health workers to 19 mothers of infants aged 7–12 months. Between September 2010 and January 2011, maternal knowledge was assessed using mixed methods, and infant nutrient intakes were assessed by 24-hour recall. We observed positive shifts in mothers' knowledge. At baseline, 63% of infants met their energy requirement and most did not receive enough folate, zinc, or calcium; none met their iron requirement. Postintervention, all infants received sufficient fat and vitamin A, and most consumed enough daily energy (79%), protein (95%), calcium (89%), zinc (89%), folate (68%), and iron (68%). The SHINE trial infant feeding intervention led to significant short-term improvements in maternal learning and infant nutrient intakes. PMID:26602298

The objective of this study was to explore cultural practices that could expose babies to HIV infection during the postnatal period in Chiota community in Zimbabwe. Purposively selected and gender disaggregated members of the community (n = 231) were informants to 23 focus group discussions and 8 semi-structured key-informant interviews. Data were analysed thematically. Emerging themes relating to risky practices were rituals surrounding open fontanelle, toning of child's sexual libido, initiation of sex after childbirth, treatment of eye and ear infections, tongue-tie and pre-mastication. These practices exposed babies to bodily fluids such as saliva, breast milk, vaginal fluids, pre-cum and semen which in turn put the babies at low to high risk of contracting HIV. This paper discusses implications for these risky practices in prevention of mother-to-child transmission of HIV. There is, therefore, need for studies to establish the prevalence of these practices. PMID:26272627

This paper reviews and reflects on the cholera outbreak that rocked Harare, Zimbabwe, in 2008/2009. We give special attention to the root causes, impacts and debates made by key stakeholders, indicating the political and geographical responses. Based on a desktop study and documentary review, the paper highlights the inadequacy of safe and clean water in most of the suburbs, the collapse of the waste management, water supply and sanitation systems of the city as the major explanations for the scourge. Despite this, Harare remains troubled with the shortage of purification chemicals, making it quite impossible to supply clean and adequate water. The national economic crisis also had a strong bearing against the performance of the public health sector. The paper concludes that sustainable urban health initiatives involving both central and local government will provide a long-term solution to the problems highlighted. PMID:25992511

Locally manufactured sodium hypochlorite (chlorine) solution has been sold in Zimbabwe since 2010. During October 1, 2011–April 30, 2012, 4,181 suspected and 52 confirmed cases of typhoid fever were identified in Harare. In response to this outbreak, chlorine tablets were distributed. To evaluate household water treatment uptake, we conducted a survey and water quality testing in 458 randomly selected households in two suburbs most affected by the outbreak. Although 75% of households were aware of chlorine solution and 85% received chlorine tablets, only 18% had reportedly treated stored water and had the recommended protective level of free chlorine residuals. Water treatment was more common among households that reported water treatment before the outbreak, and those that received free tablets during the outbreak (P < 0.01), but was not associated with chlorine solution awareness or use before the outbreak (P > 0.05). Outbreak response did not build on pre-existing prevention programs. PMID:24664784

Various soil water management practices have been developed and promoted for the semi arid areas of Zimbabwe. These include a variety of infield crop management practices that range from primary and seconday tillage approaches for crop establishment and weed management through to land forming practices such as tied ridges and land fallowing. Tillage methods evaluated in this study include deep winter ploughing, no till tied ridges, modified tied ridges, clean and mulch ripping, and planting basins. Data collected from the various trials since the 1990s show that mulch ripping and other minimum tillage practices consistently increased soil water content and crop yields compared to traditional spring ploughing. Trial results also showed higher soil loss from conventionally ploughed plots compared to plots under different minimum tillage practices.

African buffalo were introduced into a wildlife conservancy in the southeast of Zimbabwe in an effortto increase the conservancy's economic viability, which is primarily based on eco-tourism. The buffalo were infected with SAT serotypes (SAT-1, SAT-2 and SAT-3) of foot and mouth disease (FMD) virus, and in order to isolate the conservancy and prevent the transmission of FMD to adjacent populations of domestic livestock, the conservancy was surrounded by a double-fence system, 1.8 m in height. The intention was to prevent the movement of both wildlife and domestic animals across the perimeter. However, two years after the buffalo were introduced, FMD occurred in cattle farmed just outside of the conservancy. Using serological and molecular diagnostic tests, epidemiological investigations showed that it was most likely that antelope (impala or kudu), infected through contact with the buffalo herd within the conservancy, had jumped over the fence and transmitted the virus to the cattle. PMID:15861873

Sexuality in the teenager is often complicated by unplanned/unwanted pregnancy, abortion and the risks of STDs including AIDS. There is therefore a need for improved understanding of factors affecting adolescent sexuality and the implementation of programmes designed to improve their knowledge, risk awareness and subsequent behavioural outcomes. A multicentre study of reproductive health knowledge and behaviour followed by a health education intervention was undertaken amongst teenagers in selected countries of East, Central and Southern Africa. Reported here are findings at baseline derived from the Zimbabwe component on reproductive biology knowledge and behavior. A self-administered questionnaire was used among 1 689 adolescent pupils drawn from rural, urban, co-education, single sex, boarding and day secondary schools in Zimbabwe. Correct knowledge on reproductive biology as measured by the meaning and interpretation of menstruation and wet dreams varied by school from 68 pc to 86 pc, with a significant trend (p < 0,01) based on level of education at baseline. The reported mean age at which menarche took place was 13,5 years +/- 1,3 (mean +/- SD). First coitus was reported to have taken place at the mean age of 12 years for boys and 13,6 years for girls. Seventeen pc of the adolescent pupils reported that they were sexually experienced and 33,2 had relationships. There were misconceptions reported on menstruation with 23 pc reporting that it was an illness. Peers, followed by magazines were the first sources of information on various aspects of reproductive biology, both of which might not provide the correct first information. Among pupils reporting that they were sexually experienced, the largest proportion (56 pc) had unprotected sex. The findings point to the need for targeting the adolescent pupils for information on reproductive biology and increased awareness on the risks of pregnancy, STDs and HIV. PMID:8932577

IWRM-led water reforms in southern Africa have emphasised the creation of new stakeholder institutions with little explanation of how they will operate at different levels, especially at the local level. A case in point is the subsidiarity principle, which advocates for water management to be undertaken at the lowest appropriate level. The main objective of the study was to investigate the conceptualisation and application of the subsidiarity principle in the Limpopo river basin in Zimbabwe. This was done by analysing how state-led frameworks at the regional, basin, national and local level provided for local participation. These frameworks were compared to a bottom-up approach based on action research in three second tier local government administrative units (wards) in Shashe subcatchment of Mzingwane catchment. The catchment represents the entirety of the Limpopo basin in Zimbabwe. Data collection was based on document reviews, key informants, focus group discussions and participatory observations. In general the top-down efforts were found to express intent but lacked appropriately conceptualised implementation guidelines. Views of local people regarding how they could meaningfully participate in transboundary water resource management were based on practical considerations rather than theoretical abstractions. This was shown by a different conceptualisation of stakeholder identification and representation, demarcation of boundaries, role of intermediate institutions, and direct participation of local people at the basin level. The paper concludes that a bottom-up institutional model can enhance the conceptualisation and application of the subsidiarity principle. It also provides evidence that prescriptive approaches may not be the best way to achieve participatory governance in transboundary water resource management.

Farmers use different non-conventional protein supplements and different feeding strategies to aid their animals survive the dry season in Zimbabwe. The strategies can be giving supplements once a week or once every other day up to very little supplement daily. Supplements are either legume crop residues or forage legumes. However, the efficacy of the use of non-conventional protein supplements in promoting growth and at the same time lowering the age at first calving is little understood. The study tested whether supplementing with farm-formulated non-conventional feeds could reduce live weight loss during the dry season and promote live weight gain as well as early development of sexual maturity in beef cattle. In a completely randomized design, thirty dams with calves on hooves were allocated to five different treatments which were repeated during the dry season for 3 years. The 3-year study results show that weight loss can be controlled, resulting in positive growth in both the pre-weaning and post-weaning phases of growing cattle. Yearlings fed solely on natural pasture lost significant weight during the dry season as compared to supplemented groups. The period to puberty and first calving was achieved at 18 and 27 months, respectively. Using non-conventional protein supplements could thus improve livestock productivity in resource-poor farming communities. It was concluded that smallholder farmers can supplement cattle with a kilogram per day of low-cost farm-based non-conventional legume meal to improve livestock productivity in semi-arid regions of Zimbabwe. PMID:25754582

Objective(S) To determine the HIV prevalence and extent of engagement with HIV prevention and care among a representative sample of Zimbabwean sex workers working in Victoria Falls, Hwange and Mutare. Design Respondent driven sampling (RDS) surveys conducted at each site. Methods Sex workers were recruited using respondent driven sampling with each respondent limited to recruiting 2 peers. Participants completed an interviewer-administered questionnaire and provided a finger prick blood sample for HIV antibody testing. Statistical analysis took account of sampling method. Results 870 women were recruited from the three sites. HIV prevalence was between 50 and 70%. Around half of those confirmed HIV positive were aware of their HIV status and of those 50-70% reported being enrolled in HIV care programmes. Overall only 25-35% of those with laboratory-confirmed HIV were accessing antiretroviral therapy. Among those reporting they were HIV negative, 21-28% reported having an HIV test in the last 6 months. Of those tested HIV negative, most (65-82%) were unaware of their status. Around two-thirds of sex workers reported consistent condom use with their clients. As in other settings, sex workers reported high rates of gender based violence and police harassment. Conclusions This survey suggests that prevalence of HIV is high among sex workers in Zimbabwe and that their engagement with prevention, treatment and care is sub-optimal. Intensifying prevention and care interventions for sex workers has the potential to markedly reduce HIV and social risks for sex workers, their clients and the general population in Zimbabwe and elsewhere in the region. PMID:24143203

The purpose of the study was to determine factors affecting elementary female student teachers' choice of science as a major at college level in Zimbabwe. The study was conducted at one of the Primary School Teachers' Colleges in Zimbabwe. A sample of two hundred and thirty-eight female student teachers was used in the study. Of these one hundred and forty-two were non-science majors who had been randomly selected, forty-one were science majors and forty-five were math majors. Both science and math majors were a convenient sample because the total enrollment of the two groups was small. All the subjects completed a survey questionnaire that had sixty-eight items. Ten students from the non-science majors were selected for individual interviews and the same was done for the science majors. A further eighteen were selected from the non-science majors and divided into three groups of six each for focus group interviews. The same was done for the science majors. The interviews were audio taped and transcribed. Data from the survey questionnaires were analyzed using Binary Logistic Regression which predicted factors that affected students' choice of science as a major. The transcribed interview data were analyzed used using domain, taxonomic and componential analyses. Results of the study indicated that elementary female students' choice of science as a major at college level is affected by students' attitudes toward science, teacher behavior, out-of-school experiences, role models, gender stereotyping, parental influence, peer influence, in-school experiences, and societal expectations, namely cultural and social expectations.

Background Sexually transmitted infections (STIs) and Reproductive tract infections (RTIs) are responsible for high morbidity among women. We aim to quantify the magnitude of the burden and risk factors of STI/RTI s among pregnant women in Zimbabwe. Methods A cross sectional study of pregnant women enrolled at 36 weeks of gestation from the national PMTCT program. Study was conducted from three peri-urban clinics around Harare Zimbabwe offering maternal and child health services. Results A total of 691 pregnant women were enrolled. Prevalence of HSV was (51.1%), HIV (25.6%) syphilis (1.2%), Trichomonas vaginalis (11.8%), bacterial vaginosis (32.6%) and Candidiasis (39.9%). Seven percent of the women had genital warts, 3% had genital ulcers and 28% had an abnormal vaginal discharge. Prevalence of serological STIs and vaginal infections were 51% and 64% respectively. Risk factors for a positive serologic STI were increasing age above 30 years, polygamy and multigravid; adjusted OR (95% CI) 2.61(1.49-4.59), 2.16(1.06-4.39), 3.89(1.27-11.98) respectively, partner taking alcohol and number of lifetime sexual partners. For vaginal infections it was age at sexual debut; OR (95% CI) 1.60(1.06-2.42). More than 25% of the women reported previous STI treatment. Fifty two percent reported ever use of condoms and 65% were on oral contraceptives. Mean age gap for sexual partners was 6.3 years older. Conclusions There is a high morbidity of STI/RTIs in this cohort. There is need to continuously screen, counsel, treat and monitor trends of STI/RTIs to assess if behaviour changes lead to reduction in infections and their sustainability. PMID:20492681

The potential for reducing diarrhoea morbidity and improving the health status of children in developing countries using solar water disinfection (SODIS) has been demonstrated in past research. A baseline survey was conducted to explore the feasibility and necessity of introducing SODIS in peri-urban communities of Zimbabwe. The survey sought to establish drinking water quality in these areas and to determine the health and hygiene beliefs as well as practices related to water handling in the household. Microbiological water quality tests and personal interviews were carried out in Epworth township and Hopley farm, two peri-urban areas near the capital of Zimbabwe, Harare. These two areas are among the poorest settlements around Harare with 80% of inhabitants being informal settlers. Community meetings were held to introduce solar water disinfection prior to the survey. This was followed by administration of questionnaires, which aimed to investigate whether the community had ever heard about SODIS, whether they were practicing it, other means that were being used to treat drinking water as well as health and hygiene beliefs and practices. It was found out that most households cannot afford basic water treatment like boiling as firewood is expensive. People generally reported that the water was not palatable due to objectionable odour and taste. Microbiological water quality tests proved that drinking water was contaminated in both areas, which makes the water unsafe for drinking and shows the necessity of treatment. Although the majority of people interviewed had not heard of SODIS prior to the interview, attitudes towards its introduction were very positive and the intention to do SODIS in the future was high. Amongst the ones who had heard about SODIS before the study, usage was high. Plastic PET bottles, which were used for the SODIS experiments are currently unavailable and this has been identified as a potential hindrance to the successful implementation of

This study assesses the feasibility of a coal based light liquids program as a way to localize forces that determine the flow of oil into the Zimbabwean economy. Methods in End-use Energy Analysis and Econometrics in which the utilization of petroleum energy is related to economic and industrial activity are used to gain insight into the structure and behavior of petroleum utilization in that country and to forecast future requirements of this resource. The feasibility of coal liquefaction as a substitute for imported oil is assessed by the use of engineering economics in which the technical economics of competing oil supply technologies are analyzed and the best option is selected. Coal conversion technologies are numerous but all except the Fischer-Trosch indirect coal liquefaction technology are deficient in reliability as commercial ventures. The Fischer-Tropsch process by coincidence better matches Zimbabwe's product configuration than the less commercially advanced technologies. Using present value analysis to compare the coal liquefaction and the import option indicates that it is better to continue importing oil than to resort to a coal base for a portion of the oil supplies. An extended analysis taking special consideration of the risk and uncertainty factors characteristic of Zimbabwe's oil supply system indicates that the coal option is better than the import option. The relative infancy of the coal liquefaction industry and the possibility that activities responsible for the risk and uncertainty in the oil supply system will be removed in the future, however, make the adoption of the coal option an unusually risky undertaking.

An estimated 25% of the adults in urban areas of Zimbabwe are living as HIV-positive. In HIV-affected households the need for income increases with the demand for medicines, food and funeral costs. One way to mitigate this effect of the epidemic is by expanding micro enterprises that can enhance the livelihoods of urban households affected by HIV. To identify viable income-generating projects for such households, five possible projects facilitated by two HIV/AIDS support organisations were selected for assessment. These were: selling second-hand clothing, poultry-keeping and nutritional/herbal gardens, freezit-making, mobile kitchens, and payphone set-ups. A case study of 200 households benefiting from one of these projects was done in two high-density suburbs in the town of Bindura, northern Zimbabwe. Information was collected from each household four times per year, over four years (2001-2004). Information on the income generated from the micro enterprises was collected monthly during the period. Descriptive statistics were used to analyse household demographic data; income data was analysed using cost-benefit analysis and analysis of variance. The results show that all five income-generating projects were viable for these households, although some were not feasible for the most vulnerable HIV-affected households. Making more efficient use of micro enterprises can be a valuable part of mainstreaming HIV-affected people and households in urban areas, and so allow people living with HIV to have longer and more meaningful lives. PMID:25875340

California State Dept. of Education, Sacramento. Bureau of Homemaking Education.

This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…

The memorandum gives guidance to the provision and organization of library services at hospitals both for staff and for patients. It also draws attention to the assistance available from outside sources towards the development and maintenance of these services so hospital authorities may make the most effective use of the available facilities.…

The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…

Designed for both hospital personnel interested in television and audiovisual personnel entering the medical field, this handbook is a verbal and pictorial survey of what is being done with TV within the medical profession. After an introduction which answers technical questions about medical TV posed during the American Hospital Association's…

This review traces the history of the mental hospital movement, initially on the world stage, and later in India, in relation to advances in psychiatric care. Mental hospitals have played a significant role in the evolution of psychiatry to its present statusThe earliest hospital in India were established during the British colonial rule. They served as a means to isolate mentally ill persons from the societal mainstream and provide treatments that were in vogue at the time. Following India's independence, there has been a trend towards establishing general hospital psychiatry units and deinstitutionalization, while at the same time improving conditions in the existing mental hospitals.Since 1947, a series of workshops of superintendents was conducted to review the prevailing situations in mental hospitals and to propose recommendations to improve the same. Implementation of the Mental Health Act, 1987, and grovernmental focus upon mental hospital reform have paved way for a more specific and futuristic role for mental hospitals in planning psychiatric services for the new millenium, especially for severe mental illnesses. PMID:21407925

Occasional events, regular workshops, concerts, shows, artists in residence, cultural outings...Hospital does not necessarily have to be a place of silence and sadness. But this situation has not always been so straightforward as on the face of it, nothing is more incompatible with a hospital environment than music, which, by definition, is festive and noisy. PMID:20684389

An increasing number of hospitals are undertaking external revenue-generating activities to supplement their shrinking budgets. Written at the request of Leadership, this article outlines an example of a successful catering service -- a money-generating business that more Canadian hospitals could profitably consider. PMID:10127850

This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…

This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

U.S. Hospitals rely heavily on debt financing to fund major capital investments. Hospital efficiency is at least partly determined by the amount and quality of plant and equipment it uses. As such, a hospital's access to debt and credit rating may be related to its efficiency. This study explores this relationship using a broad sample of hospitals and associated bond issuance histories. Employing stochastic frontier analysis (SFA), we measure cost inefficiency to gauge the impact of debt issuance and debt rating. We find that hospitals with recent bond issues were less inefficient. Although we do not find a perfectly linear relationship between debt rating and inefficiency, we have evidence that hints at such a relation. Finally, we find an increase in inefficiency in the years following bond issues, consistent with the possibility of a debt death spiral. PMID:21110482

After 15 years of development of Hospital Medicine in Chile, there are several benefits of this discipline. Among others, a reduction in the length of hospital stay, readmissions, costs, and improved medical teaching of students, residents and fellows have been observed. However, in South América there are only isolated groups dedicated to Hospital Medicine in Chile, Argentina and Brazil, with a rather slow growth. The unjustified fear of competition from sub specialists, and the fee for service system of payment in our environment may be important factors to understand this phenomenon. The aging of the population makes imperative to improve the safety of our patients and to optimize processes and resources within the hospital, to avoid squandering healthcare resources. The following is a detailed and evidence-based article, on how hospital medicine might benefit both the public and prívate healthcare systems in Chile. PMID:23900327

Compares stewardship and hospitality as they relate to the biosphere. Traces the origin of the word "hospitality," discusses cultural traditions of hospitality, and applies the concept of hospitality to the natural world. Considers forms of symbiosis in nature: commensals, mutualism, and parasitism. Hospitality promotes respect, humility, and…

This study assessed the water quality of 144 boreholes in Bindura District in Mashonaland Province of Zimbabwe as part of a borehole rehabilitation project implemented by a local NGO. In previous studies it has been observed that some boreholes are not used for domestic purposes because of consumer perceived poor water quality. Consequently, communities have resorted to unsafe alternative water sources thus creating health risks. The study was carried out in June 2005. The objectives of the study were to assess the levels of parameters associated with the aesthetics of the water and to compare them with guideline values for drinking water. The study also investigated the relationship between some of the measured water quality and the consumer perceived water quality. Measured water quality parameters included pH, temperature, electrical conductivity (EC), turbidity, calcium (Ca), magnesium (Mg) and iron (Fe). All parameters were measured in the field except Ca, Mg and Fe, which were measured in a laboratory using a spectrophotometer. Consumer perceptions on water quality were investigated through interviews with the consumer community. Turbidity was found to be 0.75-428(20.8 ± 59.2; n = 144) NTU, pH 5.7-9.3 (6.88 ± 0.46; n = 144), temperature 18-26.8 (22.6 ± 2.1; n = 144) °C. EC 26-546 (199 ± 116; n = 144) μS/cm, Ca 6-71.6 (26.9 ± 14.1; n = 81) mg/l, Mg 1.2-49.6 (12.3 ± 10.0; n = 81) mg/l and Fe 0.08-9.60 (0.56 ± 1.15; n = 81) mg/l. Some 23% of the samples had pH outside the recommended range of 6.5-8.5, whilst 59% of the samples had turbidity values exceeding the 5NTU WHO limit. For EC, all samples had values less than the WHO derived limit of 1380 μS/cm. All Ca and magnesium values were within the common and recommended levels of 100 mg/l and 70 mg/l respectively. Iron had values greater than the WHO and SAZ limit of 0.3 mg/l in 36% of the samples. Water quality was deemed satisfactory for taste and soap consumption by 95% and 72% of the respondents

Metal pollution of freshwater due to human activities is a major problem confronting most urban centres in developing countries. This study determined the extent to which aluminium in the residues from Morton Jaffray Water Works in Harare were affecting the water quality of Manyame River and Lake Manyame. The study also measured aluminium bioaccumulation in Nile Tilapia ( Oreochromis niloticus) which is of importance to the commercial fisheries industry in Zimbabwe. Depth integrated water, and sediment grab samples and adult fish were collected per site in January and March, 2010. A total of six sites were selected on the Manyame River and in Lake Manyame. The levels of Total Aluminium (Al) were determined in sediments, water and fish tissues (liver, kidney, gill and muscle). Total solids, total dissolved solids, conductivity, pH, dissolved oxygen and temperature were also determined in water and residues. The texture of the sediments was also assessed. Aluminium concentration in water ranged from 2.19 mg/L to 68.93 mg/L during both sampling campaigns surpassing permissible maximum concentration limits of 0.087 to 0.75 mg/L suggested by the Environmental Protection Agency and African Union. The site upstream of the discharge point of the residues always had the lowest levels though it was higher than acceptable levels indicated above, thus suggesting the existence of other sources of aluminium in the catchment besides Morton Jaffray Water Works. However, there was a 10-fold and 100-fold increase in levels of aluminium in water and sediments, respectively, at the site 100 m downstream of the discharge point on the Manyame River. Mean aluminium concentrations in water and sediments at this site averaged 68.93 ± 61.74 mg/L and 38.18 ± 21.54 mg/L in water and 103.79 ± 55.96 mg/L and 131.84 ± 16.48 mg/L in sediments in sampling campaigns 1 and 2, respectively. These levels were significantly higher than levels obtained from all the other sites during both sampling

Climate change has resulted in increased vulnerability of smallholder farmers in marginal areas of Zimbabwe where there is limited capacity to adapt to changing climate. One approach that has been used to adapt to changing climate is in-field water harvesting for improved crop yields in the semi- arid regions of Zimbabwe. This review analyses the history of soil and water conservation in Zimbabwe, efforts of improving water harvesting in the post independence era, farmer driven innovations, water harvesting technologies from other regions, and future directions of water harvesting in semi arid marginal areas. From this review it was observed that the blanket recommendations that were made on the early conservation method were not suitable for marginal areas as they resulted in increased losses of the much needed water. In the late 1960 and 70s', soil and water conservation efforts was a victim of the political environment and this resulted in poor uptake. Most of the water harvesting innovations which were promoted in the 1990s' and some farmer driven innovations improved crop yields in marginal areas but were poorly taken up by farmers because they are labour intensive as the structures should be made annually. To address the challenges of labour shortages, the use of permanent in-field water harvesting technologies are an option. There is also need to identify ways for promoting water harvesting techniques that have been proven to work and to explore farmer-led knowledge sharing platforms for scaling up proven technologies. PMID:23543041

The Nile crocodile (Crocodylus niloticus) is a large aquatic reptile predominant in the tropics in Africa and Zimbabwe in particular. Clutch sizes and hatching rates of Nile crocodile eggs collected from the wild and on-farm in Lowveld, Highveld and Kariba regions of Zimbabwe were evaluated. A total of 274 egg records for the period 2000 to 2008 from 39 farms were collected from the Crocodile Farmers Association of Zimbabwe. The effect of source of eggs was analysed using the non-parametric one way analysis of variance procedure of SAS Version 9.1.3. Wilcoxon signed rank test for independent samples was used to compare the mean hatching rates and clutch sizes for eggs collected from the different sources by region. The degree of association between clutch sizes and the hatching rates by source and region was determined using the Spearman's rank correlation test. Source of eggs had no effect (P > 0.05) on hatching rates in all the regions but significantly influenced (P < 0.05) clutch sizes in Lowveld and Kariba. In these regions, clutch sizes in the wild were significantly (P < 0.05) higher than those on-farm. Correlation estimates between clutch size and hatching rates were weak and non-significant (P > 0.05) for the different sources of eggs in all regions. Full utilization of the wild resource would reduce challenges relating to shortage of captive breeders and high cost of rearing breeders and hence increase productivity. PMID:21947863

Background Blood collected in conventional EDTA tubes requires laboratory analysis within 48 hours to provide valid CD4 cell count results. This restricts access to HIV care for patients from rural areas in resource-constraint settings due to sample transportation problems. Stabilization Tubes with extended storage duration have been developed but not yet evaluated comprehensively. Objective To investigate stability of absolute CD4 cell count measurement of samples in BD Vacutainer CD4 Stabilization Tubes over the course of 30 days. Methods This was a laboratory-based method comparison study conducted at a rural district hospital in Beitbridge, Zimbabwe. Whole peripheral blood from 88 HIV positive adults was drawn into BD Vacutainer CD4 Stabilization Tubes and re-tested 1, 2, 3, 5, 7, 14 and 30 days after collection on BD FacsCount and Partec Cyflow cytometers in parallel. Absolute CD4 cell levels were compared to results from paired samples in EDTA tubes analysed on BD FacsCount at the day of sample collection (references methodology). Bland-Altman analysis based on ratios of the median CD4 counts was used, with acceptable variation ranges for Limits of Agreements of +/-20%. Results Differences in ratios of the medians remained below 10% until day 21 on BD FacsCount and until day 5 on Partec Cyflow. Variations of Limits of Agreement were beyond 20% after day 1 on both cytometers. Specimen quality decreased steadily after day 5, with only 68% and 40% of samples yielding results on BD FacsCount and Partec Cyflow at day 21, respectively. Conclusions We do not recommend the use of BD Vacutainer CD4 Stabilization Tubes for absolute CD4 cell count measurement on BD FacsCount or Partec Cyflow due to large variation of results and decay of specimen quality. Alternative technologies for enhanced CD4 testing in settings with limited laboratory and sample transportation capacity still need to be developed. PMID:26295802

OBJECTIVE. This study explores the relationships among donations to not-for-profit hospitals, the returns provided by these hospitals, and fund-raising efforts. It tests a model of hospital behavior and addresses an earlier debate regarding the supply price of donations. DATA SOURCES. The main data source is the California Office of Statewide Health Planning data tapes of hospital financial disclosure reports for fiscal years 1980/1981 through 1986/1987. Complete data were available for 160 hospitals. STUDY DESIGN. Three structural equations (donations, returns, and fund-raising) are estimated as a system using a fixed-effects, pooled cross-section, time-series least squares regression. PRINCIPAL FINDINGS. Estimation results reveal the expected positive relation between donations and returns. The reverse relation between returns and donations is insignificant. The estimated effect of fund-raising on donations is insignificantly different from zero, and the effect of donations on fund-raising is negative. Fund-raising and returns are negatively associated with one another. CONCLUSION. The empirical results presented here suggest a positive donations-returns relations and are consistent with a positive supply price for donations. Hospitals appear to view a trade-off between providing returns and soliciting donations, but donors do not respond equally to these two activities. Attempts to increase free cash flow through expansion of community returns or fund-raising activity, at least in the short run, are not likely to be highly successful financing strategies for many hospitals. PMID:8537223

This study aimed to enhance understanding of the dimensions of accountability captured and not captured in acute care hospitals in Ontario, Canada. Based on an Ontario-wide survey and follow-up interviews with three acute care hospitals in the Greater Toronto Area, we found that the two dominant dimensions of hospital accountability being reported are financial and quality performance. These two dimensions drove both internal and external reporting. Hospitals' internal reports typically included performance measures that were required or mandated in external reports. Although respondents saw reporting as a valuable mechanism for hospitals and the health system to monitor and track progress against desired outcomes, multiple challenges with current reporting requirements were communicated, including the following: 58% of survey respondents indicated that performance-reporting resources were insufficient; manual data capture and performance reporting were prevalent, with the majority of hospitals lacking sophisticated tools or technology to effectively capture, analyze and report performance data; hospitals tended to focus on those processes and outcomes with high measurability; and 53% of respondents indicated that valuable cross-system accountability, performance measures or both were not captured by current reporting requirements. PMID:25305387

This study aimed to enhance understanding of the dimensions of accountability captured and not captured in acute care hospitals in Ontario, Canada. Based on an Ontario-wide survey and follow-up interviews with three acute care hospitals in the Greater Toronto Area, we found that the two dominant dimensions of hospital accountability being reported are financial and quality performance. These two dimensions drove both internal and external reporting. Hospitals' internal reports typically included performance measures that were required or mandated in external reports. Although respondents saw reporting as a valuable mechanism for hospitals and the health system to monitor and track progress against desired outcomes, multiple challenges with current reporting requirements were communicated, including the following: 58% of survey respondents indicated that performance-reporting resources were insufficient; manual data capture and performance reporting were prevalent, with the majority of hospitals lacking sophisticated tools or technology to effectively capture, analyze and report performance data; hospitals tended to focus on those processes and outcomes with high measurability; and 53% of respondents indicated that valuable cross-system accountability, performance measures or both were not captured by current reporting requirements. PMID:25305387

... but can also be caused by fungi. Hospital construction. Hospital staff do everything they can to prevent ... patients staying at hospitals where there is ongoing construction or renovation. 5 This is thought to be ...

Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW) management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices. PMID:25657950

The Norwegian block grant reform of 1980 replaced state reimbursements to hospitals by block grants allocated to counties according to objective criteria. The reform was accompanied by a general decentralization of budget authority to local level. The reform aimed to promote primary care, equalize the supply of health care across regions and give counties incentives to improve hospital efficiency. A decade later, the reform was reversed. The government has imposed restrictions which reduce the budget discretion of the counties and part of the block grant has been made dependent on the performance of the hospitals in the counties. The government has also issued a 'waiting-list guarantee' which states that patients who suffer from a serious disease are entitled to medical treatment within six months. This paper provides an overview of hospital financing in Norway during the last two decades and discusses why the block grant system did not fulfil the expectations of its architects. PMID:10136059

... CAH Conditions of Participation . What are the location requirements for CAH status? Critical Access Hospitals must be ... clinic that does not meet the CAH distance requirements? As of January 1, 2008, all CAHs, including ...

... to know whether your hospital charged a fair price. There are some web sites you can use ... zip code to find an average or estimated price in your area. www.healthcarebluebook.com www.fairhealth. ...

... Bed? Todd says that there is no standard definition for hospital beds, a fact that consumers shopping ... in retail stores that don’t meet the definition of medical devices under the law, but which ...

Hospital managers may find it difficult to admit their investments have been suboptimal, but such investments often lead to poor returns and less future cash. Inappropriate use of free cash flow produces large transaction costs of exit. The relative efficiency of investor-owned and tax-exempt hospitals in the product market for hospital services is examined as the free cash flow theory is used to explore capital-market conditions of hospitals. Hypotheses concerning the current competitive conditions in the industry are set forth, and the implications of free cash flow for risk, capital-market efficiency, and the cost of capital to tax-exempt institution is compared to capital-market norms. PMID:1743965

In December 2011 marked 80 years of the founding of the Ryazan garrison hospital, originally housed in two buildings: "Redut housed"--a monument of architecture of the XVIII century and the former almshouses room "for the maimed in the war", was built in 1884 now Ryazan garrison hospital (from 2010--Branch No 6 FSI "in 1586 the district military hospital in the Western Military District", the Defense Ministry of Russia)--a multi-field medical preventive institution on the basis of which soldiers, military retirees, family members and military retirees from Ryazan, Moscow, Tambov regions are treated. Every year more than 7 thousand patients get treatment here. During the counterterrorism operations in Chechnya over 800 wounded were brought to the hospital from the battle area. PMID:22558855

Working well together at hospital depends on several factors, on the level of a team as well as that of the ministry in charge of health. How can we encourage and promote cooperation between caregivers? If the hospital is the reflection of society as a whole, an analysis of the functioning of this universe provides a better understanding of the challenges and the missions of each player for the benefit of the patient. PMID:26144821

Hospital leaders should consider four factors in determining whether to fast track a hospital construction project: Expectations of project length, quality, and cost. Whether decisions can be made quickly as issues arise. Their own time commitment to the project, as well as that of architects, engineers, construction managers, and others. The extent to which they are willing to share with the design and construction teams how and why decisions are being made. PMID:23513759

There are many considerations when managing feedyard hospitals. The type of hospital system must fit the facility design, the type of cattle fed at the feedyard, the crew that is employed by the feedyard, and the protocol established by the veterinarian. Ensuring the animals are well-cared for and have their basic needs met should be the priority of the feedyard personnel and the veterinarian maintaining the veterinarian-client-patient relationship with the feedyard. PMID:26210766

Indoor air quality has deteriorated so much since the 1970s oil shortage and subsequent energy-efficient construction of buildings that people are becoming seriously ill by just breathing the indoor air. This is a problem with all industrial buildings and hospital staff are at particular risk. There are various things that hospital managers from different departments can do to make the air safe for staff and patients to breathe. PMID:11185833

Undue emphasis has been placed on rising rates of readmission to psychiatric facilities. After a decade of preoccupation with discharge rates, readmission statistics have been singled out in the last 15 years as the key factor for assessing hospital effectiveness. A study of a group of patients at high risk for recurrent hospitalization revealed that these patients were characterized more by features relating to environmental supports than by diagnosis. The operational definition for recurrent hospitalization (five or more admissions during the 2-year period preceding the latest admission) was effective in identifying this group; this is the first reported instance in which the definition has specified a certain number of admissions within a time-limited period. The findings of this study, as well as of an analysis of case histories and consumer opinion, led to the design of a pilot program for persons undergoing recurrent hospitalization. Readmission statistics are useless or misleading as measures of hospital effectiveness and efficiency; what matters is the way the former patients function in the community after discharge. Rather than simply trying to reduce the readmission rate psychiatric facilities should be examining the types of persons who are hospitalized recurrently to develop programs aimed at improving the functioning of these people in the community. PMID:630483

Health service accreditation systems have explicit standards for organisation against which the participating hospital assesses itself before a structured visit by outside "surveyors". They submit a written report back to the hospital with commendations and recommendations for development prior to a follow-up survey. Accreditation may be awarded for a fixed term or may be with held by an independent assessment Board if the hospital does not meet a defined threshold of standards. In Europe, some government and medical organisations initially distanced themselves from the pilot hospital wide programmes, arguing that they would cost too much and undermine management, or that they were irrelevant to clinical practice. But gradually it became obvious that accreditation worked for hospitals; purchasers and insurers saw its potential for quality and resource management; and professional bodies recognised the links between clinical training, practice and outcome and the environment in which health care is provided. If nothing else, it offered a multi-professional bridge between the existing numerous fragmented systems such as inspecting (statutory safety), visiting (professional training), and monitoring (service contracts). The introduction of accreditation appears to benefit hospitals in many different countries and health systems and provides a vehicle for integrated quality management which is visible to funding agencies, government and the public. Interest is growing within Europe. PMID:10179643

Disaster preparedness and response have gained increased attention in the United States as a result of terrorism and disaster threats. However, funding of hospital preparedness, especially surge capacity, has lagged behind other preparedness priorities. Only a small portion of the money allocated for national preparedness is directed toward health care, and hospitals receive very little of that. Under current policy, virtually the entire funding stream for hospital preparedness comes from general tax revenues. Medical payers (e.g., Medicare, Medicaid, and private insurance) directly fund little, if any, of the current bill. Funding options to improve preparedness include increasing the current federal grants allocated to hospitals, using payer fees or a tax to subsidize preparedness, and financing other forms of expansion capability, such as mobile hospitals. Alternatively, the status quo of marginal preparedness can be maintained. In any event, achieving higher levels of preparedness likely will take the combined commitment of the hospital industry, public and private payers, and federal, state, and local governments. Ultimately, the costs of preparedness will be borne by the public in the form of taxes, higher healthcare costs, or through the acceptance of greater risk. PMID:18087914

Gender equality and education are being promoted as strategies to combat the HIV epidemic in Africa, but few studies have looked at the role of gender equality and education in the uptake of a vital service - HIV testing. This study looks at the associations between education (a key input needed for gender equality) and key gender equality measures (financial decision making and attitudes toward violence) with ever tested for HIV and tested for HIV in the past year. The study focused on currently married women ages between15-24 and 25-34 in three countries - Kenya, Zambia, and Zimbabwe. The data came from the Demographic and Health Surveys. Logistic regression was used to study the role of gender equality and education on the HIV testing outcomes after controlling for both social and biological factors. Results indicated that education had a consistent positive relationship with testing for both age groups, and the associations were always significant for young women aged 15-24 years (p<0.01). The belief that gender-based violence is unacceptable was positively associated with testing for women aged 25-34 in all the three countries, although the associations were only significant in Kenya (among women reporting ever being tested: OR 1.58, p<0.00; among women reporting being tested in the past year: OR 1.34, p<0.05) and Zambia (among women reporting ever being tested: OR 1.24, p<0.10; among women reporting being tested in the past year: OR 1.29, p<0.05). High financial decision making was associated with testing for women aged 25-34 in Zimbabwe only (among women reporting ever being tested: OR 1.66, p<0.01). Overall, the findings indicate that the education and the promotion of gender equality are important strategies for increasing uptake of a vital HIV service, and thus are important tools for protecting girls and young women against HIV. PMID:23438082

Instrumental weather records in southern Africa are largely limited to the last 100 years and documentary weather-related data are rare prior to the 1800s, hindering our understanding of the natural and/or anthropogenic factors that influence climate variability over this region. Measuring stable isotopes ratios (commonly 13C/12C and 18O/16O) in tree rings can provide a good proxy for extending climate data beyond the instrumental record. The objective of this study is to characterize historical variations in the climatology underlying extreme climatic events in Zimbabwe using instrumental climate records (precipitation and temperature) and a multi-proxy approach (ring width, δ18O, and δ13C) for dendroclimatic proxy reconstructions. A 90-year (1900-1990) δ18O and δ13C tree ring record using four Pterocarpus angolensis samples is being developed and compared to tree ring width, monthly, seasonal, and annual precipitation totals, meteoric water δ18O values, and mean monthly and seasonal temperature. Preliminary results indicate significant correlations between the average δ18O record and the previous year December precipitation totals (r=0.41, p<0.0001), current year January precipitation totals (r=0.45, p<0.0001), and combined total precipitation for the previous year November and December and current year January (r=0.57, p<0.0001). Furthermore, we find that the δ18O values are strongly influenced by maximum temperature during the previous year December (r=0.39, p=0.0001) and current year January (r=0.40, p=0.0001), and average maximum temperature during the months of the previous year December and current year January and February (r=0.47, p<0.001). We thus present one of the first studies to integrate a multi-proxy approach to investigate historical climate variability in southern Africa using ring widths, and tree ring δ18O and δ13C values of trees growing in Zimbabwe.

Objectives Schools are often cited as a source of support for orphans and children affected by HIV/AIDS in populations experiencing generalized HIV epidemics and severe poverty. Here we investigate the success of schools at including and supporting the well being of vulnerable children in rural Zimbabwe. Design Data from a cross-sectional household survey of 4577 children (aged 6–17 years), conducted between 2009 and 2011, were linked to data on the characteristics of 28 primary schools and 18 secondary schools from a parallel monitoring and evaluation facility survey. Methods We construct two measures of school quality (one general and one HIV-specific) and use multivariable regression to test whether these were associated with improved educational outcomes and well being for vulnerable children. Results School quality was not associated with primary or secondary school attendance, but was associated with children’s being in the correct grade for age [adjusted odds ratio 2.0, 95% confidence interval (CI) 1.2–3.5, P = 0.01]. General and HIV-specific school quality had significant positive effects on well being in the primary school-age children (coefficient 5.1, 95% CI 2.4–7.7, P < 0.01 and coefficient 3.0, 95% CI 0.4–5.6, P = 0.02, respectively), but not in the secondary school-age children (P > 0.2). There was no evidence that school quality provided an additional benefit to the well being of vulnerable children. Community HIV prevalence was negatively associated with well being in the secondary school-age children (coefficient −0.7, 95% CI −1.3 to −0.1, P = 0.03). Conclusions General and HIV-specific school quality may enhance the well being of primary school-age children in eastern Zimbabwe. Local community context also plays an important role in child well being. PMID:24991911

Groundwater from boreholes and shallow wells is a major source of drinking water in most rural areas of Zimbabwe. The quality of groundwater has been taken for granted and the status and the potential threats to groundwater quality have not been investigated on a large scale in Zimbabwe. A borehole and shallow well water quality survey was undertaken between January, 2009 and February, 2010 to determine the chemical and microbial aspects of drinking water in three catchment areas. Groundwater quality physico-chemical indicators used in this study were nitrates, chloride, water hardness, conductivity, alkalinity, total dissolved solids, iron, magnesium, manganese, potassium, calcium, fluoride, sulphates, sodium and pH. The microbiological indicators were total coliforms, faecal coliforms and heterotrophs. Principal component analysis (PCA) showed that most of the variation in ground water quality in all catchment areas is accounted for by Total Dissolved Solids (TDS), electrical conductivity (EC), sodium, bicarbonate and magnesium. The principal dissolved constituents in ground water are in the form of electrically charged ions. Nitrate is a significant problem as the World Health Organization recommended levels were exceeded in 36%, 37% and 22% of the boreholes in the Manyame, Mazowe and Gwayi catchment areas respectively. The nitrate levels were particularly high in commercial farming areas. Iron and manganese also exceeded the recommended levels. The probable source of high iron levels is the underlying geology of the area which is dominated by dolerites. Dolerites weather to give soils rich in iron and other mafic minerals. The high level of manganese is probably due to the lithology of the rock as well as mining activity in some areas. Water hardness is a problem in all catchment areas, particularly in the Gwayi catchment area where a value of 2550 mg/l was recorded in one borehole. The problems with hard water use are discussed. Chloride levels exceeded the

The status of Canadian hospital pharmacy and the impact of national hospital insurance on its development are discussed. The provision of health care services for Canadians is shared by the federal and provincial governments. The federal government enacts protective and regulatory legislation, compiles health statistics, promotes research, and provides direct health care for those citizens for whom it is directly responsible. Each province is responsible for hospitals, the education and training of health care professionals, public health, and the financing and administration of health insurance for all its citizens. Largely because of line-item budget allocations and a bureaucratic tendency to equalize services for the whole population, funds for existing pharmaceutical services have been assured but the introduction of upgraded or innovative programs has been difficult to achieve. The result has been an even quality of health care services, including pharmacy, throughout the country and a deficiency in clinical pharmacy programs and the trained personnel to run them. The last decade has brought advances, however, as allocation methods have changed and both hospital and insurance administrators have recognized the patient benefits and cost effectiveness of many of the newer pharmacy programs. The main challenges facing Canadian hospital pharmacy are to upgrade clinical services and education and to improve managerial and bureaucratic competence among department directors. PMID:7377213

In this study of 162 hospitals, it was found that the chief executive officer's (CEO's) interpretation of strategic issues is related to the existing hospital strategy and the hospital's information processing structure. Strategy was related to interpretation in terms of the extent to which a given strategic issue was perceived as controllable or uncontrollable. Structure was related to the extent to which an issue was defined as positive or negative, was labeled as controllable or uncontrollable, and was perceived as leading to a gain or a loss. Together, strategy and structure accounted for a significant part of the variance in CEO interpretations of strategic events. The theoretical and managerial implications of these findings are discussed. PMID:1991677

A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission) across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113%) than prices paid to all other California hospitals (70%). Prices were similar in both groups at the start of the period (approximately $9200 per admission). By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country. PMID:27284126

Objectives. Using a randomized controlled trial in rural eastern Zimbabwe, we tested whether comprehensive support to keep orphan adolescent girls in school could reduce HIV risk. Methods. All orphan girls in grade 6 in 25 primary schools were invited to participate in the study in fall 2007 (n = 329). Primary schools were randomized to condition. All primary schools received a universal daily feeding program; intervention participants received fees, uniforms, and a school-based helper to monitor attendance and resolve problems. We conducted annual surveys and collected additional information on school dropout, marriage, and pregnancy rates. We analyzed data using generalized estimating equations over 3 time points, controlling for school and age at baseline. Results. The intervention reduced school dropout by 82% and marriage by 63% after 2 years. Compared with control participants, the intervention group reported greater school bonding, better future expectations, more equitable gender attitudes, and more concerns about the consequences of sex. Conclusions. We found promising evidence that comprehensive school support may reduce HIV risk for orphan girls. Further study, including assessment of dose response, cost benefit, and HIV and herpes simplex virus 2 biomarker measurement, is warranted. PMID:21493943

Quantitative studies indicate that HIV incidence in Zimbabwe declined since the late 1990s, due in part to behavior change. This qualitative study, involving focus group discussions with 200 women and men, two dozen key informant interviews, and historical mapping of HIV prevention programs, found that exposure to relatives and close friends dying of AIDS, leading to increased perceived HIV risk, was the principal explanation for behavior change. Growing poverty, which reduced men's ability to afford multiple partners, was also commonly cited as contributing to reductions in casual, commercial and extra-marital sex. HIV prevention programs and services were secondarily mentioned as having contributed but no specific activities were consistently indicated, although some popular culture influences appear pivotal. This qualitative study found that behavior change resulted primarily from increased interpersonal communication about HIV due to high personal exposure to AIDS mortality and a correct understanding of sexual HIV transmission, due to relatively high education levels and probably also to information provided by HIV programs. PMID:20803064

Grandparents throughout sub-Saharan Africa have shown immense courage and fortitude in providing care and support for AIDS-affected children. However, growing old comes with a number of challenges which can compromise the quality of care and support they are able to provide, particularly for children infected by HIV and enrolled on antiretroviral therapy (ART) programmes. For ART to be effective, and for infected children not to develop drug-resistance, a complex treatment regimen must be followed. Drawing on the perspectives of 25 nurses and eight grandparents of HIV-infected children in Manicaland, eastern Zimbabwe, we explore some of the challenges faced by grandparents in sustaining children's adherence to ART. These challenges, serving as barriers to paediatric ART, are poverty, immobility, deteriorating memory and poor comprehension of complex treatments. Although older HIV-infected children were found to play an active role in sustaining the adherence to their programme of treatment by contributing to income and food generating activities and reminding their guardians about check-ups and drug administration, such contribution was not available from younger children. There is therefore an urgent need to develop ART services that both take into consideration the needs of elderly guardians and acknowledge and enhance the agency of older children as active and responsible contributors to ART adherence. PMID:21400306

While the advent of antiretroviral therapy (ART) has increased survival and reduced the number of acquired immune-deficiency syndrome (AIDS) related deaths among people living with the human immunodeficiency virus (HIV) virus (PLHIV), HIV/AIDS remains a global health problem and sub-Saharan Africa continues to bear the greatest burden of disease. There are also major challenges in the HIV response: as of December 2013, only 36% of PLHIV globally were on ART, and for every individual started on ART there were two new PLHIV diagnosed. This has led to considerable debate around adopting an HIV ‘treat all’ approach aimed at greatly escalating the number of PLHIV initiated and retained on ART, regardless of CD4 cell count or World Health Organization (WHO) clinical stage, with the intended goal of achieving viral suppression which should in turn reduce HIV transmission, morbidity and mortality in affected individuals. This paper examines the issues being discussed in Zimbabwe, a low-income country with a high burden of HIV/AIDS, about the implications and opportunities of adopting an HIV ‘treat all’ approach, along with pertinent operational research questions that need to be answered to move the agenda forward. These discussions are timely, given the recent WHO recommendations advising ART for all PLHIV, regardless of CD4 cell count. PMID:27051603

Quantitative studies indicate that HIV incidence in Zimbabwe declined since the late 1990s, due in part to behavior change. This qualitative study, involving focus group discussions with 200 women and men, two dozen key informant interviews, and historical mapping of HIV prevention programs, found that exposure to relatives and close friends dying of AIDS, leading to increased perceived HIV risk, was the principal explanation for behavior change. Growing poverty, which reduced men’s ability to afford multiple partners, was also commonly cited as contributing to reductions in casual, commercial and extra-marital sex. HIV prevention programs and services were secondarily mentioned as having contributed but no specific activities were consistently indicated, although some popular culture influences appear pivotal. This qualitative study found that behavior change resulted primarily from increased interpersonal communication about HIV due to high personal exposure to AIDS mortality and a correct understanding of sexual HIV transmission, due to relatively high education levels and probably also to information provided by HIV programs. PMID:20803064

Climate variability is set to increase, characterised by extreme conditions in Africa. Southern Africa will likely get drier and experience more extreme weather conditions, particularly droughts and floods. However, while climate risks are acknowledged to be a serious threat to smallholder farmers' livelihoods, these risks do not exist in isolation, but rather, compound a multiplicity of stressors. It was important for this study to understand farmer perceptions regarding the role of climate risks within a complex and multifarious set of risks to farmers' livelihoods. This study used both qualitative and quantitative methods to investigate farmers' perceptions regarding threats to livelihoods in southern Zambia and south-western Zimbabwe. While farmers report changes in local climatic conditions consistent with climate variability, there is a problem in assigning contribution of climate variability and other factors to observed negative impacts on the agricultural and socio-economic system. Furthermore, while there is a multiplicity of stressors that confront farmers, climate variability remains the most critical and exacerbate livelihood insecurity for those farmers with higher levels of vulnerability to these stressors. PMID:22425874

We assess gender differences in HIV prevention knowledge, attitudes and practices with a focus on cultural, sociological, and economic variables. A randomized cross-sectional study was used in order to achieve high participation and broad comparative assessment. An eight-page questionnaire was administered to 933 randomly selected students at the University of Zimbabwe. Survey items addressed sexual decision-making, condom use, limiting sexual partners, cultural power dynamics and access to HIV testing. We found marked gender differences with men reporting beliefs of entitlement to dominate women, an assumed leadership in decision-making concerning condom use and an attitude that when a woman says "no" to sex, really, "it depends." Women acknowledged gender-based cultural attitudes but are much more likely to support women's rights to sexual expression. A multi-faceted approach to gender equity training is needed to challenge men and women to change attitudes and increase social awareness that respects cultural traditions while still inspiring both men and women to champion justice and equality between genders. PMID:17690049

Parasites of the tigerfish (Hydrocynus vittatus) were investigated in the period October 2014 to July 2015 in the Sanyati Basin, Lake Kariba. The fish were collected using seine netting and also during the annual Kariba International Tiger Fishing Tournament. A total of 80 fish specimens (24 males and 56 females) were collected and were infected with the following seven parasite taxa: Monogenea (Annulotrema sp.1 from the gills and Annulotrema sp.2 from the skin), Nematoda (Contracaecum larvae), Cestoda (bothriocephalid, larval cyclophyllid), Copepoda (Lamproglena hemprichii), pentastomid, Myxosporea (Myxobolus sp.,) and unicellular ciliate parasites (Trichodina sp., Tetrahymena sp., and unidentified). Annulotrema sp. 1 was observed in all fish and had the highest prevalence, mean intensity and abundance. The fish organs infected were gills, skin, fin, body cavity, stomach, intestines, mesentery, liver, kidney, brain cavity and swim bladder. No parasites were observed in the muscle, eyes and blood. The distribution of the parasites was highest in the gills and lowest in the brain cavity and swimbladder. Bothriocephalids, pentastomes and Trichodina sp. were not observed in male fish. Sex was not related to the intensity of parasites. The results of the study showed that H. vittatus has a richer parasite community than other previous investigated alestids. Pentastomes, Myxobolus sp., Trichodina sp., Tetrahymena sp. and bothriocephalid cestodes are new records for H. vittatus in Zimbabwe. PMID:27447228

The purpose of this study was to explore the audits, quality assurance (QA) programmes and legal frameworks used in selected abattoirs in Zimbabwe and slaughterhouse workers' perceptions on their effectiveness. Data on slaughterhouse workers was gathered through a self-completed questionnaire and additional information was obtained from slaughterhouse and government records. External auditing was conducted mainly by the Department of Veterinary Public Health with little contribution from third parties. Internal auditing was restricted to export abattoirs. The checklist used on auditing lacked objective assessment criteria and respondents cited several faults in the current audit system. Most respondents (> 50.0%) knew the purposes and benefits of audit and QA inspections. All export abattoirs had QA programmes such as hazard analysis critical control point and ISO 9001 (a standard used to certify businesses' quality management systems) but their implementation varied from minimal to nil. The main regulatory defect observed was lack of requirements for a QA programme. Audit and quality assurance communications to the selected abattoirs revealed a variety of non-compliances with most respondents revealing that corrective actions to audit (84.3%) and quality assurance (92.3%) shortfalls were not done. A high percentage of respondents indicated that training on quality (76.8%) and regulations (69.8%) was critical. Thus, it is imperative that these abattoirs develop a food safety management system comprising of QA programmes, a microbial assessment scheme, regulatory compliance, standard operating procedures, internal and external auditing and training of workers. PMID:24396908

We investigated the sexist application of a morality concept of Tsika, characterized by communal traits, in the Shona culture of Zimbabwe. Tsika has been defined as "politeness, civility and circumlocution" (Samkange & Samkange, 1980, p. 74), thus generally falling under communal traits. Theoretical literature suggests that although Tsika is a cultural ideal for all Shona people, it is especially expected of women and children, and that women can be punished like children if they lack Tsika. This research tested whether Tsika would be expected more of women (and children) than men. In line with ambivalent sexism theory, it was predicted that, because Tsika is constituted of communal traits, a bias in its expectation of women over men would be predicted by benevolent sexism. Furthermore, the research tested whether women (and children) would be judged more negatively than men if they defaulted on Tsika. It was hypothesized that a more negative evaluation of women than men if they defaulted on Tsika would be predicted by hostile sexism. Results confirmed that Tsika is expected more of women than of men. Benevolent sexism and its interaction with hostile sexism predicted the bias in expectation of Tsika of women over men. Results also confirmed that women who default on Tsika are evaluated more negatively than men. Hostile sexism predicted the bias in negative evaluations of women over men who default on Tsika. PMID:23425299

Many librarians do not see themselves as marketers, but marketing is an essential role for hospital librarians. Library work involves education, and there are parallels between marketing and education as described in this article. It is incumbent upon hospital librarians actively to pursue ways of reminding their customers about library services. This article reinforces the idea that marketing is an element in many of the things that librarians already do, and includes a list of suggested marketing strategies intended to remind administrators, physicians, and other customers that they have libraries in their organizations. PMID:15982957

A clinical and functional integration strategy has a positive influence on increasing hospital revenue, and a solely functional integration strategy has a negative influence on increasing hospital expenses. Functional integration and clinical/functional integration strategies have a positive influence on hospital profit and the overall operations of the hospital. The mechanism of influence differs, however, based on the strategy used. Clinical/functional strategy has an impact on increasing hospital revenue, while functional integration strategy has an impact on reducing hospital expenses. Overall, the study shows that a functional integration strategy is more profitable than a clinical/functional integration strategy. PMID:15816230

This study examines the relationship between hospital structural characteristics and patient satisfaction with hospital care. Teaching hospitals and private hospitals were expected to receive higher ratings of patient satisfaction than were nonteaching and government-controlled hospitals, because they generally are reputed to be technologically superior. Results show that, in general, most patients are satisfied with their hospital stays, but they are clearly more dissatisfied with their stays in teaching hospitals. Although a number of other correlates of patient satisfaction with the hospital stay are identified, no measure succeeds in reducing to insignificance the strong relationship between teaching status and dissatisfaction. Some suggestions are made as to why teaching hospital receive relatively poor evaluations from their patients. PMID:7228714

The phrase, 'hospital information system', is frequently used in discussions about the flow of information throughout a hospital with the assumption that everybody has the same concept in mind. Closer examination shows that this is not necessarily the case. The author draws on his experience as the Chief Information Officer at University Hospital at Stony Brook to define a hospital information system in terms of the implementation at Stony Brook. The University Hospital Information System at University Hospital (UHIS), has received international acclaim and was recently selected by the IBM Quarterly of Australia as the world leader in hospital information systems. This paper answers four questions: What is a hospital information system? How does a hospital information system work? How do you implement a hospital information system? After the system is operational, where do you go, e.g., critical care data management, physician's office management? University Hospital at Stony Brook is located on eastern Long Island and is the tertiary care referral hospital for approximately 1.4 million people. Nothing in the hospital happens without computers. Doctors, nurses, administrators and staff at all levels rely on the system daily. The system operates 24 hours per day, seven days per week. Access to the system is through 300 terminals and 128 printers throughout the hospital. In addition to the UHIS terminals, the critical care management system which is called Patient Data Management System, (PDMS), is available at over 90 ICU beds and in the operating rooms. PMID:3585130

This year Zemun Hospital--Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia.The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the"Kontumac"--a quarantine established in 1730. Soon after, two more confessional hospitals were opened.The Serbian (Orthodox) Hospital was founded before 1769, whereas the German (Catholic) Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall--the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time.The final, physical merging of these hospitals was completed in 1795. PMID:25233701

Increasingly, organizations are experiencing changes as a result of extensive downsizing, restructuring, and merging. In Canada, government-sponsored medicine has been affected as hospitals have merged or closed, reducing essential medical services and resulting in extensive job loss for hospital workers, particularly nurses. Hospital restructuring has also resulted in greater stress and job insecurity in nurses. The escalation of stressors has created burnout in nurses. This study examines predictors of burnout in nurses experiencing hospital restructuring using the MBI-General Survey which yields scores on three scales: Emotional exhaustion, Cynicism, and Professional efficacy. Multiple regressions were conducted where each burnout scale was the criterion and stressors (e.g., amount of work, use of generic workers to do nurses' work), restructuring effects, social support, and individual resources (e.g., control coping, self-efficacy, prior organizational commitment) were predictors. There were differences in the amount of variance accounted for in the burnout components by stressors and resources. Stressors contributed most to emotional exhaustion and least to professional efficacy. Individual resources were more likely to contribute to professional efficacy and least to emotional exhaustion. Stressors and resources accounted for approximately equal amounts of variance in cynicism. Three conclusions were drawn. First, present findings parallel others by showing that individual coping patterns contribute to professional efficacy. Second, emotional exhaustion was found to be the prototype of stress. Third, prior organizational commitment, self-efficacy, and control coping resulted in lower burnout. PMID:15137570

Although this handbook is addressed primarily to the hopital administrator, it contains material of interest to the librarian as well. Basic requirements for providing good library services to hospital staff are identified as: (1) well chosen and well trained manpower; (2) a current collection of information materials; and (3) appropriate space in…

Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…

Modern hospitals are complex multi-product organisations. The analysis of a hospital's production and/or cost structure should therefore use the appropriate techniques. Flexible functional forms based on the neo-classical theory of the firm seem to be most suitable. Using neo-classical cost functions implicitly assumes minimisation of (variable) costs given that input prices and outputs are exogenous. Local and global properties of flexible functional forms and short-run versus long-run equilibrium are further issues that require thorough investigation. In order to put the results based on econometric estimations of cost functions in the right perspective, it is important to keep these considerations in mind when using flexible functional forms. The more recent studies seem to agree that hospitals generally do not operate in their long-run equilibrium (they tend to over-invest in capital (capacity and equipment)) and that it is therefore appropriate to estimate a short-run variable cost function. However, few studies explicitly take into account the implicit assumptions and restrictions embedded in the models they use. An alternative method to explain differences in costs uses management accounting techniques to identify the cost drivers of overhead costs. Related issues such as cost-shifting and cost-adjusting behaviour of hospitals and the influence of market structure on competition, prices and costs are also discussed shortly. PMID:12220092

The design of a modern hospital owes more to engineering than the layman may realize. In this context, many engineers are in the position of laymen, being unfamiliar with the multitude of services that lies behind the impressive facade of a modern hospital. In recent years medicine and surgery themselves have taken on many of the characteristics of a technology. This has required a matching development of the services both mechanical and electrical that are required in modern health care buildings. In medical terms, if the architectural features provide the 'skin' of the hospital, the mechanical and electrical engineering services provide the nerves and sinews. If we take as an example the recently completed Freeman Hospital, Newcastle upon Tyne, (Fig. 1), which cost 10 million pounds at current cost, the service network was responsible for about half the total cost. About 400 miles (643 km) of electrical wiring and more than 40 mile (64.5 km) of copper and steel piping were used to service 3000 separate rooms. This compares with percentages of between 18 and 25 per cent for other large buildings such as office blocks, hotels and sports complexes. PMID:10273268

This study corresponds to an estimated 142,250 admissions for peptic ulcer to the wards of National Health Service hospitals in England and Wales during the two years 1956 and 1957. It presents a picture of the incidence and mortality of complications and surgical treatment throughout England and Wales. PMID:14036965

There are eight classes of men in the military hospital including attendants, and for each class there should be a different dietary. Major Hoskins explains this, tells clearly the common sources of waste of food, notes the amount, and suggests lines of conservation. Imagesp435-a PMID:18010115

Young people face sexual and reproductive health (SRH) problems including Human immunodeficiency virus (HIV) and Acquired immunodeficiency syndrome (AIDS). It is critical to continue documenting their situation including the contexts they live in. As part of a larger study that explored perspectives of men to SRH and more specifically abortion and contraceptive use, 546 pupils (51% female; age range 9-25 years) from a rural area in Zimbabwe were invited to write anonymously questions about growing up or other questions they could not ask adults for fear or shame. The pupils were included following descriptions by adults of the violence that is unleashed on unmarried young people who engaged in sex, used contraceptives, or simply suggested doing so. The questions by the young people pointed to living in a context of prohibitive silence; their sexuality was silenced and denied. As a consequence they had poor knowledge and their fears and internal conflicts around sexuality and pregnancy were not addressed. Current action suggests concerted effort at the policy level to deal with young people's SRH in Zimbabwe. It nevertheless remains necessary, as a way to provide support to these efforts, to continue examining what lessons can be drawn from the past, and how the past continues to reflect in and shape present dynamics and relations. There is also need to look more critically at life skill education, which has previously been described as having failed to address adequately the practical needs of young people. Life skill education in Zimbabwe has rarely been systematically evaluated. A fuller understanding is also needed of the different factors co-existing in contemporary African societies and how they have been and continue to be constituted within history, and the implications to the promotion of adolescent SRH. PMID:23372653

Background: Results from recent costing studies have put into question potential Voluntary Medical Male Circumcision (VMMC) cost savings with the introduction of the PrePex device. Methods: We evaluated the cost drivers and the overall unit cost of VMMC for a variety of service delivery models providing either surgical VMMC or both PrePex and surgery using current program data in Zimbabwe and Zambia. In Zimbabwe, 3 hypothetical PrePex only models were also included. For all models, clients aged 18 years and older were assumed to be medically eligible for PrePex and uptake was based on current program data from sites providing both methods. Direct costs included costs for consumables, including surgical VMMC kits for the forceps-guided method, device (US $12), human resources, demand creation, supply chain, waste management, training, and transport. Results: Results for both countries suggest limited potential for PrePex to generate cost savings when adding the device to current surgical service delivery models. However, results for the hypothetical rural Integrated PrePex model in Zimbabwe suggest the potential for material unit cost savings (US $35 per VMMC vs. US $65–69 for existing surgical models). Conclusions: This analysis illustrates that models designed to leverage PrePex's advantages, namely the potential for integrating services in rural clinics and less stringent infrastructure requirements, may present opportunities for improved cost efficiency and service integration. Countries seeking to scale up VMMC in rural settings might consider integrating PrePex only MC services at the primary health care level to reduce costs while also increasing VMMC access and coverage. PMID:27331598